Nearly all CPC practices continued into CPC+, and the reductions in ED visits persisted and grew significantly over time. Moving forward, the Innovation Center seeks to harmonize model evaluation measures with quality measures used to determine payment to the greatest extent possible and better capture the impact of care delivery changes on quality and beneficiary experience, including through patient-reported outcome measures.Ĭomprehensive Primary Care practices significantly slowed growth in emergency department (ED) visits but not hospitalizations relative to comparison practices. 7 However, the evaluation could not assess performance based on eCQMs because data were unavailable for comparison practices. Among the 11 core electronic clinical quality measures (eCQMs), improvements for 3 measures were greater in CPC practices than practices that formed the benchmark. The independent CPC evaluation found no significant difference from control practices on claims-based measures of diabetes care processes or continuity of care among attributed Medicare beneficiaries. Five major lessons emerged from this review.Ĭhanges in Quality and Total Cost of Care Are Challenging to Detect Within a 5-Year Period In doing so, it reviewed data and practice feedback from several primary care initiatives: the Comprehensive Primary Care (CPC) (2012-2015) and Comprehensive Primary Care Plus (CPC+) (2017-2021) models and the Primary Care First (PCF) (2021-2026) model. The Innovation Center has tested models to increase access to advanced, integrated primary care in many communities. 3 Furthermore, the proportion of beneficiaries seeing 5 or more physicians annually increased from 18% to 30% between 20. Nearly 30% of beneficiaries have 2 or 3 chronic conditions, 22% have 4 or 5, and 18% have 6 or more. 2 However, Medicare beneficiaries are facing greater clinical and system complexity requiring better coordination of primary and specialty care. The National Academies of Sciences, Engineering, and Medicine (NASEM) report on primary care in 2021 highlighted its vital role in the health care system in promoting better population health and equitable outcomes. To support this vision, the CMS Innovation Center announced an ambitious goal for the year 2030: to have 100% of beneficiaries in traditional Medicare and most Medicaid beneficiaries in accountable care relationships with providers who are responsible for the quality and the total cost of care, mostly through advanced primary care or accountable care organizations. The Centers for Medicare & Medicaid Services (CMS) is committed to advancing health equity, expanding coverage, and improving health outcomes. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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