CMMI Evaluation Digest July 2022

 

 

July 2022 This newsletter highlights recently released Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) evaluation reports and publications. You can access reports by going to the data and reports page of the Innovation Center website. Reports highlighted in this edition: Comprehensive Primary Care Plus (CPC+) Model: Fourth Annual Report Financial Alignment Initiative (FAI): New York Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities Demonstration: Preliminary Combined First and Second Evaluation Report Financial Alignment Initiative (FAI): Texas Dual Eligible Integrated Care Demonstration: Preliminary Second Evaluation Report

 

Comprehensive Primary Care Plus (CPC+) Model Fourth Annual Report - Key Takeaways: CPC+ was the largest and most ambitious primary care payment and delivery reform model ever tested in the United States. In the fourth year of CPC+, practices’ ability to work on CPC+ care delivery requirements was hindered by the COVID-19 pandemic. Yet, the range of supports provided by CMS, payer partners, and health IT vendors and temporary reliefs granted through changes in payment policies helped practices continue to make important changes to care. CPC+ reduced acute care utilization and acute inpatient expenditures and improved some claims-based quality-of-care measures. Some types of expenditures increased, so CPC+ did not reduce total Medicare expenditures without enhanced payments and expenditures including enhanced payments increased. However, reductions in total expenditures without enhanced payments emerged in Performance Year 4 for Medicare Shared Savings Program (SSP) practices, especially in Track 1. The final report will further explore these positive trends. The Two Page Overview: Findings At-a-Glance (PDF) The Report (includes an Executive Summary): Fourth Annual Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendices: Methodology and Supporting Tables. Includes a study of exemplar practices (Appendix 4.C) and detailed results over the first four program years of CPC+ (Appendix 5) Model Pages: Comprehensive Primary Care Plus (CPC+) Model  |  Primary Care First (PCF) Model Financial Alignment Initiative (FAI): New York Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities Demonstration Preliminary Combined First and Second Evaluation Report - Key Takeaways: Stakeholders perceived the care management model employed in this demonstration as uniquely comprehensive, providing individuals with a level of control over a wide range of detailed choices impacting their everyday lives. Although the lack of participation by a major health care system used by many eligible beneficiaries and opt-in only enrollment have contributed to low enrollment levels, low voluntary disenrollment rates suggest that enrollees and their advocates are satisfied with the demonstration. The Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) demonstration increased Medicare expenditures for eligible beneficiaries in the first 2 years of the demonstration but did not have an impact on Medicaid expenditures. The demonstration has been extended until December 31, 2023. The Two Page Overview: Findings At-a-Glance (PDF) The Report (includes an Executive Summary): Preliminary Combined First and Second Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendix: Data Sources and Quality Measure Performance (PDF) Model Page: Financial Alignment Initiative (FAI) Financial Alignment Initiative (FAI): Texas Dual Eligible Integrated Care Demonstration Preliminary Second Evaluation Report - Key Takeaways:  In the first 3 demonstration years, the Texas Dual Eligible Integrated Care demonstration had mixed results on service use and quality. The demonstration had no impact on Medicare costs while generating Medicaid savings cumulatively and in all 3 demonstration years. Measures of beneficiary experience andMedicare-Medicaid Plan (MMP) performance have improved over the course of the demonstration to date, although improvement has been uneven across MMPs. The Two Page Overview: Findings-At-A-Glance (PDF) The Report (includes an Executive Summary): Preliminary Second Evaluation Report (PDF) Go directly to the Executive Summary (PDF) Additional Supporting Materials: Appendix: Methods and Supporting Tables  (PDF) Model Page: Financial Alignment Initiative (FAI)

 

The CMS Innovation Center maintains a portfolio supporting the development and testing of innovative health care payment and service delivery models. It performs evaluations of these models and makes the results available to the public. Bringing you the latest CMS Innovation Center Evaluation Results: Watch out for future issues of our Evaluation Digest,  check out the CMS Innovation Center website, and follow us on Twitter.