Care Practice (MAPCP) Demonstration AcademyHealth June 2016 Donald - - PowerPoint PPT Presentation

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The Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration

AcademyHealth June 2016

Donald Nichols, PhD

Acknowledgement and Disclaimer

This project was funded by the Centers for Medicare & Medicaid Services under contract no. HHSM-500-2010-00021I. The statements contained in this presentation are solely those of the authors and do not necessarily reflect the views or policies of the Centers for Medicare & Medicaid Services. RTI assumes responsibility for the accuracy and completeness of the information contained in this report.

Overview of MAPCP Demonstration

• Medicare participated in 8 state-led multi-payer PCMH initiatives,

along with Medicaid and commercial payers

– NY, RI, VT, NC, MN, ME, MI, PA

• MAPCP Demonstrations began in 2011 through 2012
• Initially a 3 year demonstration

– Extended until the end of 2016 in some states: NY, RI, VT, ME, and MI – Evaluation goes through December 2014

State and Payer Inputs

• Financial support (e.g.,

payments to practices and supports)

• Technical support (e.g.,

learning collaboratives, coaching)

• Claims data (e.g., data

and performance reports)

Practice Outputs

• Enhance practice

infrastructure (e.g., health IT, staffing)

• Provide advanced

primary care services (e.g., care coordination)

Expected Patient Outcomes

• Cost savings
• Efficient utilization
• High quality of care

and patient experiences

MAPCP Participation

State Participating Practices Attributed Medicare Participants Attributed All- payer Participants New York 37 27,707 100,033 Rhode Island 16 12,631 59,251 Vermont 125 78,881 271,282 North Carolina 40 33,154 81,925 Minnesota 208 159,460 1,050,003 Maine 70 59,548 140,082 Michigan 312 299,897 1,175,586 Pennsylvania 44 41,640 153,597 852 712,918 3,031,759

Evaluation Design

• Mixed methods evaluation

– Difference-in-differences – Comparative case study – Qualitative comparison analysis

• Qualitative data sources

– Annual site visits – Medicare and Medicaid beneficiary focus groups (late 2014)

• Quantitative data sources

– Medicare fee-for-service (FFS) beneficiary enrollment and claims

data

– Medicaid enrollment and claims/encounter data – Medicare beneficiary survey (mid 2014) – Practice transformation survey (early 2015)

Results

• Transformation accomplishments

– Integration of care management/coordination activities and staff was focus

• f transformation process

– Expansion of patient access

• It took states longer than expected to operationalize initiatives, thus

they felt 3 years was not enough time to reduce cost or improve health outcomes

– Saved Medicare a combined $323 million through the second year of the

demonstration

– NY, ME, and MI reduced hospital admissions – MI and MN reduced 30-day unplanned readmissions – ME was only state to reduce ER visits not leading to hospitalization

• Importance of multi-payer aspect of demonstration

– Greater payer participation provided greater momentum – Sustainability and scalability depended on practices’ receiving payment for

a critical mass of patients

More Information

Donald Nichols Project Director dnichols@rti.org Susan Haber Deputy Project Director shaber@rti.org Melissa Romaire Deputy Project Director mromaire@rti.org