The Center for Medicare and Medicaid Innovation (CMMI) has recently announced an initiative called Comprehensive Primary Care Plus (CPC+), evolved from the previous Comprehensive Primary Care (CPP) initiative. The initiative mainly consists on paying a fee to those primary care practices willing to introduce organizational changes centered in five primary care functions:  (1) access and continuity; (2) care management; (3) comprehensiveness and coordination; (4) patient and caregiver engagement; and, (5) planned care and population health.

In this post, the authors outline some of the promises and downsides of the PCC+. On the bright side, the authors analyse how financial incentives can make primary care practices introduce innovations that may lead to improvements in the quality of their clinical performance. On the other side, two main downsides are mentioned: (I) the lack of incentives to achieve good results in the care that takes place beyond the primary care services -hospital admissions and referrals to hospital specialists- and (II) the inability of physicians participating in CPC+ to participate in accountable care organizations (ACOs).