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The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
October 6, 2022
Policy Report
Daniel Porreca
Niam Yaraghi
Publication
Jul 13, 2026
Apr 14, 2026
Feb 12, 2026
Analysis of the Comprehensive Primary Care (CPC) program found that the lack of infrastructure for health information exchange was a barrier for primary care practices participating in this federal multipayer advanced primary care program. This study examines whether population health management information technologies offered through a health information exchange (HIE) platform—which collects and stores data across providers—helped practices in the follow-up program, Comprehensive Primary Care Plus (CPC+), achieve better outcomes. We conducted a retrospective study to examine several outcome measures among a sample of 37 participating primary care practices in western New York. These practices were grouped in four categories based on their participation in CPC+ and population health information technology services. Over the course of January 2020 to December 2020, practices with membership in both CPC+ and HIE saw 24.1% lower risk-adjusted hospital admission rates and 21.0% lower risk-adjusted outpatient surgery rates compared with practices that didn’t participate in either one. Average lengths of stay in hospitals were 32.7% lower and readmission rates were 30.4% lower. Given these observations, which are based on a robust and mature HIE system, we encourage the medical practices that participated in the CPC+ program or are engaged in other multipayer advanced primary care opportunities to also subscribe to population health management information technologies.
Read the report
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