Investment of Medicare in primary care indicates progress

The Centers for Medicare & Medicaid Services (CMS) declared the Comprehensive Primary Care (CPC) initiative’s 2nd round of shared savings results today, with almost entire practices (95%) meeting quality of care requirements and 4 out of 7 regions sharing in savings with CMS. The work of 481 practices were reflected by these results that served about 376,000 Medicare beneficiaries and more than 2.7 million sufferers overall in the year of 2015.

CPC shows the potential of primary care clinicians redesigning their practices to deliver improved care to their sufferers, and gives clinicians support to innovate and deliver care in ways that better meet their patients’ requirements and preferences.

During the time of 2015, its 2nd shared savings performance year, a total of $57.7 million gross savings in Part A and Part B expenditures were generated by CPC. These savings are significantly equivalent to the $58 million paid in care management fees to the practices. In CPC, 4 of the 7 regions participating – the states of Arkansas, and Oregon, Colorado, and the Greater Tulsa region in Oklahoma – realized net savings and will share in those savings with CMS. However, 3 of the CPC regions had net losses, the savings generated in the other 4 regions covered those losses. Moreover, more than half of participating CPC practices will get a share of over $13 million in earned shared savings.

CPC practices indicated positive quality, with lower than expected hospital admission and readmission amounts, and remarkable performance on patient experience measures. Performance of CPC practices on electronic Clinical Quality Measures (eCQMs) also exceeded national benchmarks, specifically on preventive health measures.

CMS has included eCQM performance for the very first time in Medicare shared savings determinations for CPC. The whole practice population is being covered by the eCQM reporting at the practice site level is crucial to utilizing health information technology as a device to support care delivery transformation. The data of eCQM are recorded in the EHR in the routine course of clinical care, permitting practices to participate in real time quality improvement efforts that drive population health. CPC practices are at the forefront of utilziing eCQMs for quality improvement, measurement, and reporting as we shift to a healthcare system that rewards value over volume.

From the 2015 shared savings performance year, the Quality highlights involve:

• Almost entire (99%) practices reported higher levels of colorectal cancer screening and influenza immunization in contrast to national benchmarks. Furthermore, 100% of practices who reported on screening for clinical depression surpassed national benchmarks.
• 97% of CPC practices victoriously reported nine eCQMs. For 10 out of the 11 eCQMs in the CPC measure set, many CPC practices who reported surpassed the median national performance.
• In contrast to 2014 year, most regions maintained or made better their scores on hospital readmissions and admissions for chronic obstructive pulmonary disorder and congestive heart failure.
• The care was rated by the patients they got from their CPC practitioners highly, specifically on how well practitioners supported them in looking after their own health and the attention they paid to care from other providers.

The positive and outstanding performance is basically a testimony to the attempts CPC practices have made to give truly “comprehensive primary care.”

Primary care transformation consumes time, and it is particularly motivating that CPC practices maintained such positive quality of care results while also observing gross Medicare savings in the 2015 performance year.
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CMS hopes that CPC+ (Comprehensive Primary Care Plus) could meet the criteria to qualify as an Advanced Alternative Payment Model under the  Quality Payment Program rule (recently finalized), which executes the Medicare Access and CHIP Reauthorization Act of 2015. To acquire better care, smarter spending, and healthier people, a robust primary care system is necessary. CMS is devoted to supporting primary care clinicians for this very reason to deliver the best, most comprehensive primary care possible for their sufferers.