Earlier this summer, the Milbank Memorial Fund – a New York-based foundation working to improve population health by connecting leaders and decision makers with the best available evidence and experience – did just that. In June, it brought together leaders from the government’s Center for Medicare & Medicaid Innovation (CMMI) with a number of the payers – Medicare, Medicaid, and commercial plans alike – involved in the Comprehensive Primary Care (CPC) initiative to discuss advances in multi-payer reform. Helping facilitate this meeting was Lisa Dulsky Watkins, MD, Onpoint’s clinical advisor and director of the Multi-State Collaborative at the Fund. 

The Fund’s meeting was a follow-up to a session which they also convened earlier this year at which CMS announced positive (albeit modest) first-year findings from its CPC initiative and Multi-payer Primary Care Practice (MAPCP) demonstration. This summer’s follow-up meeting was a chance for participants in the CPC initiative to share information, observations, and outcomes after having six months to synthesize and examine CMS’s first annual reports on the subject. 

“This was a broader sharing of information than at the first meeting,” comments Dulsky Watkins in a recent Milbank report. Participating payers were given the floor to address the dimensions of multi-payer alignment within the CPC model that have been effective so far – and to discuss those that could be adjusted in transforming primary care service delivery and payment processes.

Bringing together payers for face-to-face meetings to share and compare notes can yield fruitful discussions about methodologies and lessons learned – something the Fund, a nationally recognized convener of healthcare leaders and decision makers, knows well. The Fund also recognizes that sharing program results after only a year-and-a-half of activity is unrealistic, a challenge also noted in CMS’s first annual reports. To date, while some of the smaller payers involved in CPC initiatives are already showing cost savings and quality improvement, some of the larger payers still don’t have results to share.

In a June 2015 Issue Brief by Rocky Mountain Health Plans, Dulsky Watkins explains that “it’s taken a while to get information that helps us learn about whether these programs are working.” If transformative and sustainable changes across systems of healthcare – and the evaluation of those changes’ effectiveness in positively impacting patients, standards, and practices – are going to be driven by accessing and interpreting meaningful data, notes Dulsky Watkins, then it’s necessary for that data to first be collected and made available.  

But fear not, she advises: “This is something the Multi-State Collaborative has been saying all along: Standard evaluation periods are much too short.” Giving multi-payer reform programs like the CPC initiative ample time – five to 10 years, for example – to sufficiently collect and use the data will give future evaluations more credible evidence to judge.

“What is the connection between the intervention and its impact on value? It may take a while to get it, but there has to be an answer,” adds Dulsky Watkins in the June 2015 brief. “Appropriate evaluation happens only when an initiative is given enough time to succeed or fail.”