This week, new results emerged from the federal government's largest-ever effort to improve primary care for people who rely on Medicare – the Comprehensive Primary Care Initiative. The results are being published in the New England Journal of Medicine.
A University of Michigan Medical School primary care physician who has studied Medicare authored the editorial in NEJM addressing the implications of the new results.
John Z. Ayanian, M.D., M.P.P., directs the U-M Institute for Healthcare Policy and Innovation, and has studied Medicare's efforts over the years to move the needle on the health and quality of care of seniors.
He and co-author Mary Beth Hamel, M.D., M.P.H. Executive Deputy Editor of NEJM, note that these new findings from the first two years of the four-year Comprehensive Primary Care Initiative show modest improvements in patient experience, while costs and quality measures did not change significantly.
To truly "bend the cost curve" for Medicare, while also improving care and supporting primary care physicians, efforts must extend beyond primary care, Ayanian and Hamel note.
"The initiative provides a down payment on the promotion of such changes, but much more remains to be learned from this initiative and others about how to implement large-scale changes that make primary care better for patients and more satisfying for physicians and their teams," they write.
Going forward, they call for future efforts to integrate primary care more effectively with specialty care and hospital care, and stronger financial incentives structured in ways that will motivate real change by all providers.
At the same time, they say, other changes will be needed to the structure and culture of primary care – and the federal government should ensure rigorous evaluation of the results of all its efforts.
The Centers for Medicare and Medicaid Services announced this week a new project with stronger financial incentives, called Comprehensive Primary Care Plus.
Dr. Ayanian is available to discuss what this study of the Comprehensive Primary Care Initiative means for American healthcare and the seniors who depend on Medicare.