Adam A. Markovitz, University of Michigan, Ann Arbor, Michigan.
Roslyn C. Murray, University of Michigan.
Health Aff (Millwood). 2022 Sep;41(9):1255-1262. doi: 10.1377/hlthaff.2021.01982.
Comprehensive Primary Care Plus (CPC+) was a multipayer payment reform model that provided incentives for primary care practices to lower spending and improve quality performance. Although CPC+ has been evaluated in Medicare, little is known about its impact in the private sector. Using claims and enrollment data from the period 2013-20 from two large insurers in Michigan, we performed difference-in-differences analyses and found that CPC+ was not associated with changes in total spending (-$44.70 per year) or overall quality performance (-0.1 percentage point). These changes did not vary systematically across CPC+ cohorts, tracks, regions, or participation in prior primary care innovations. We conclude that CPC+ did not improve spending or quality for private-plan enrollees in Michigan, even before accounting for payouts to providers. This analysis adds to existing evidence that CPC+ may cost payers money in the short term, without concomitant improvements to care quality.
综合初级保健加（CPC+）是一种多付款人支付改革模式，为初级保健实践提供激励，以降低支出并提高质量绩效。尽管 CPC+已在医疗保险中进行了评估，但在私营部门的影响知之甚少。我们使用密歇根州两家大型保险公司在 2013-20 年期间的索赔和参保数据，进行了差异分析，发现 CPC+与总支出变化（每年减少 44.70 美元）或整体质量绩效（无变化）无关。这些变化在 CPC+队列、轨道、地区或之前参与初级保健创新方面没有系统差异。我们的结论是，即使在不考虑向提供者支付款项的情况下，CPC+也没有改善密歇根州私人计划参保者的支出或质量。这项分析增加了现有证据，表明 CPC+可能会在短期内使支付者花钱，而不会同时提高护理质量。
