Transforming the Delivery of Primary Care

HealthDay News — Two years into the Comprehensive Primary Care Initiative, practices have made progress toward transforming delivery of primary care but have not yet shown savings in expenditures, according to a study published in the New England Journal of Medicine.

Stacy Berg Dale, MPA, from Mathematica Policy Research in Chicago, and colleagues tracked changes in the delivery of care by practices participating in the Comprehensive Primary Care Initiative that was started in October 2012. Data were included for 497 primary care practices in 7 regions across the United States.

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The researchers found that initiative practices received a median of $115 000 per clinician in care-management fees during the first 2 years. Improvements were reported in approaches to the delivery of primary care in areas such as management of high-risk patients and enhanced access to care. 

There were no significant differences between initiative and comparison practices in terms of changes in average monthly Medicare expenditures per beneficiary, regardless of whether care-management fees were taken into account or not. 

Relative to comparison practices, initiative practices had a 3% reduction in primary care visits (P < 0.001) and small improvements in two of the 6 domains of patient experience.

“Midway through this four-year intervention, practices participating in the initiative have reported progress in transforming the delivery of primary care,” the authors wrote.


Dale SB, Ghosh A, Peikes DN, Day TJ, Yoon FB, Taylor EF, et al. Two-Year Costs and Quality in the Comprehensive Primary Care Initiative. N Engl J Med. 2016; doi: 10.1056/NEJMsa1414953.