Supports to CPC+ Practices


HealthTeamWorks has been on the frontlines of primary care transformation for more than 25 years. The 501(c)(3) nonprofit exists today to solve complex health care problems in the pursuit of health, equity, and resilience. This requires increasing successful Alternative Payment Model (APM) participation, fostering resilience in primary care, and bridging clinical, public health, and communities. HealthTeamWorks’ pronounced footprint in primary care transformation was most recently evidenced in the Independent Evaluation of Comprehensive Primary Care Plus (CPC+) Final Report. HealthTeamWorks served as faculty on the CPC+ National Learning Network and facilitators in two Regional Learning Networks. 

CPC+ was the largest, most ambitious primary care delivery and payment reform model tested in the United States. Launched in 2017 by the Centers for Medicare & Medicaid Services (CMS), the five-year program explored the hypothesis that practices could realize primary care delivery transformation by coalescing multipayer payment reform, actionable data, health IT support, and robust learning supports.

CPC+ included two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the United States. Through a unique public-private partnership with 61 aligned payers in 18 regions, the CPC+ payment redesign gave practices the additional financial resources and flexibility needed to make investments to improve quality of care and reduce the number of unnecessary services their patients received.

With help from the learning supports, such as the CPC+ Implementation Guide and direct practice coaching, which HealthTeamWorks co-authored and provided, respectively, CPC+ practices implemented change tactics related to five primary care functions by the end of the testing period in December 2021: access and continuity, care management, comprehensiveness and coordination, patient and caregiver coordination, and planned care and population health.

CPC+ Learning Supports rated high

One goal of the model was to help CPC+ practices achieve the triple aim – better health, better care, and smarter spending. HealthTeamWorks provided regional support to 187 designated CPC+ practices in Colorado and 35 in Nebraska to help them get there. 

HealthTeamWorks’ roles included helping establish and manage the National Learning Network component of the Learning System for CPC+ and leading the Colorado and Nebraska Regional Learning Networks. The National Learning Network and Regional Learning Networks together comprised the full Learning System for CPC+. The CPC+ Learning System was designed to optimize performance of the CPC+ model by providing actionable data and effectively capturing and diffusing new knowledge among participating practices, payers (including CMS), and HIT vendors, and fully engage participating practices, payers, and other stakeholders in achieving the CPC+ aims.

When practices were asked to rate the usefulness of CPC+ learning supports, they scored high. In Program Years 2 through 4, about 90% of participants rated the learning supports as very useful or somewhat useful.

A graph of a number of percentages

In another instance, CPC+ practices were asked about their perception of the [value] of various learning supports offered in Program Year 4. Among several learning supports, this rating included the CPC+ Implementation Guide HealthTeamWorks co-authored. 96% of practices indicated the Guide was very or somewhat useful. Telephone/virtual coaching also received a 92% utility rating.