How CPC+ Supported Patient Care During the COVID-19 Pandemic: Lessons for Alternative Payment Models

How CPC+ Supported Patient Care During the COVID-19 Pandemic: Lessons for Alternative Payment Models

Published: Apr 10, 2024
Publisher: ScienceDirect Healthcare, vol. 12, issue 2
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Associated Project

Evaluating the Nation's Largest Primary Care Delivery Model: Comprehensive Primary Care Plus (CPC+)

Time frame: 2016–2023

Prepared for:

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services

U.S. Department of Health and Human Services, Center for Medicare & Medicaid Innovation

Authors

Nancy Duda

Kaylyn Swankoski

Gillian Giudice

Maya Palakal

Caroline Mack

Key Findings
  • CPC + helped buffer many primary care practices from pandemic-related shocks
  • Most participants were positive or neutral about CPC+ in the context of COVID-19.
  • Larger and rural participants were more positive than smaller and suburban ones.
  • Care management, access, payment, and staffing were most commonly lauded.

Background

A growing literature documents how primary care practices adapted to the COVID-19 pandemic. We examine a topic that has received less attention—how participants in an advanced alternative payment model perceive the model influenced their ability to meet patients’ care needs during the pandemic.


Methods

Analysis of closed- and open-ended questions from a 2021 survey of 2496 practices participating in the Comprehensive Primary Care Plus (CPC+) model (92% response rate) and a 2021 survey of 993 randomly selected primary care physicians from these practices (55% response rate). Both surveys asked whether respondents agreed or disagreed that they or their practice was “better positioned to meet patients' care needs during the coronavirus pandemic” because of participation in CPC+. Both also included an open-ended question about CPC+’s effects.


Results

Half of practices and one-third of physicians agreed or strongly agreed that participating in CPC+ better positioned them to meet patients' care needs during the pandemic. One in 10 practices and 2 in 10 physicians, disagreed or strongly disagreed, while 4 in 10 practices and slightly more than half of physicians neither agreed nor disagreed (or, for physicians, didn't know). The most commonly identified CPC+ activities that facilitated meeting patient care needs related to practices' work on care management (e.g., risk stratification), access (e.g., telehealth), payment outside of fee-for-service (FFS), and staffing (e.g., supporting care managers).


Conclusions

Most CPC+ practices and physicians were positive or neutral about participating in CPC+ in the context of COVID-19, indicating more benefit than risk to payment alternatives to FFS.

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