Participation in the Comprehensive Primary Care Plus Initiative

Area of Science:

• Health Services Research
• Primary Care Reform
• Healthcare Payment Models

Background:

• Comprehensive Primary Care Plus (CPC+) is a large-scale initiative to reform primary care delivery and payment.
• The program supports over 3,000 practices through enhanced payments, HIT support, and practice transformation.
• Understanding participation patterns and practice characteristics is crucial for evaluating the program's impact.

Purpose of the Study:

• To analyze participation rates in the CPC+ program.
• To identify characteristics of primary care practices that participated in CPC+ compared to non-participating practices within CPC+ regions.

Main Methods:

• Utilized a unique dataset of all US primary care practices.
• Compared practices within CPC+ regions, including applicants and participants.
• Analyzed differences between CPC+ model tracks for participating practices.

Main Results:

• Only 15% of primary care practices in CPC+ regions participated, with 22% applying.
• Applicant practices were generally larger, more technologically advanced (EHRs), hospital-affiliated, experienced with transformation, and located in urban areas.
• Applicant practices served slightly healthier and more advantaged Medicare beneficiaries.

Conclusions:

• CPC+ participants are not representative of all primary care practices.
• There is a need to engage small, independent, rural practices, and those lacking transformation experience.
• Evaluation results should be interpreted with caution due to potential selection bias.