Staffing Patterns of Comprehensive Primary Care Practices (cpc)

Evaluation of the Comprehensive Primary Care Initiative

Examines staff size and composition of the 496 advanced primary care practices participating in CMS's comprehensive primary care initiative, in 7 regions (states or local areas) that were selected for the demonstration.

Study Overview

• Status: Completed
• Conditions: Medicare Expenditures and Hospital Use, All Conditions
• Intervention / Treatment: Other: Comprehensive primary care

Detailed Description

Participating practices all have electronic health records, submitted applications to participate in this demonstration program designed to improve primary care practices, and were selected as the most advanced of the applicants in terms of use of health information technology and certification as a medical home or possessing features similar to those of a medical home. Participating practices will receive monthly payments from Centers for Medicare & Medicaid (CMS) for Medicare patients attributed to the practice, and from other payers in the market taht are participating in the initiative. The demonstration began in October 2012 and will continue for 4 years. This early paper focuses on describing these practices at the outset of the demonstration.

• Study Type: Observational
• Enrollment (Actual): 15000

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Medicare patients enrolled in traditional Medicare who receive the majority of their Evaluation and Management visits from one of the study practices.

Description

Inclusion Criteria:

• All Medicare fee-for-service patients who receive the majority of their Evaluation and Management visits from one of the study practices.

Exclusion Criteria:

• none.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Comprehensive primary care practices; Comprehensive primary care practices are the intervention group.	Other: Comprehensive primary care; Practices participating in the comprehensive primary care initiative receive a monthly amount from Centers for Medicare and Medicaid Services for each attributed Medicare patient, plus technical support of a learning collaborative, and can share in any net savings generated.
Comparison practices; Comparison practices are the case-control group--the matched set of practices in a comparison area--whose patients' outcomes will be compared to those of intervention practices.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Medicare expenditures per year for patients attributed to the practice	Four years

Secondary Outcome Measures

Outcome Measure	Time Frame
number of preventable hospitalizations	four years

Other Outcome Measures

Outcome Measure	Time Frame
number of emergency room admissions	four years

Collaborators and Investigators

• Sponsor: Mathematica Policy Research, Inc.
• Investigators: Principal Investigator: Randall S Brown, PhD, Mathematica Policy Research

Study record dates

Study Major Dates

• Study Start: October 1, 2012
• Primary Completion (Actual): October 1, 2016
• Study Completion (Actual): May 1, 2018

Study Registration Dates

• First Submitted: April 1, 2013
• First Submitted That Met QC Criteria: April 8, 2013
• First Posted (Estimate): April 9, 2013

Study Record Updates

• Last Update Posted (Actual): August 16, 2018
• Last Update Submitted That Met QC Criteria: August 14, 2018
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Keywords: primary care, Medicare costs, hospitalizations
• Other Study ID Numbers: cpc32813

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: not allowed; data belong to the federal government