Physician Groups Earn Over $25 Million for Quality Improvements

Janice Simmons, for HealthLeaders Media , August 19, 2009

All 10 of the physician groups participating in the Centers for Medicare and Medicaid Services' Physician Group Practice (PGP) Demonstration achieved benchmark performance on at least 28 of the 32 measures reported in the third year of the pilot demonstration. As a result of their efforts to reduce the growth rate in Medicare expenditures, five of those physician groups are receiving performance payments totaling $25.3 million as part of their share of $32.3 million of savings generated for the Medicare Trust Funds for the year.

Over the first three years of the demonstration, the physician groups increased their quality scores an average of 10 percentage points on 10 diabetes measures, 11 points on 10 congestive heart failure measures, 6 points on seven coronary artery disease measures, 10 points on two cancer screening measures, and 1 percentage point on three hypertension measures.

Two of the groups—Geisinger Clinic, headquartered in Danville, PA, and Park Nicollet Health Services, headquartered in St. Louis Park, MN—achieved benchmark performance on all 32 performance measures.

The demonstration seeks to encourage coordination of Medicare Part A and Part B services, promote efficiency through investment and administrative structure and processes, and include electronic medical records and chronic disease management strategies, said Donald Fisher, PhD, president and CEO of the American Medical Group Association, in Alexandria, VA, which sponsored a teleconference yesterday with representatives of the 10 medical groups.

"The results of this demonstration clearly show that these types of organizations—which can be referred to as accountable care organizations—can significantly improve the cost and quality of care in America," Fisher said. "Better quality is less costly, and this demonstration definitely demonstrates that ACOs are a viable model, and any healthcare reform proposal should address reimbursement policy such that it promotes these types of organizations."

Fred Bloom, MD, assistant chief quality officer with Geisinger, said in the teleconference that Geisinger has focused on hard wiring reminders and alerts into the patients' electronic health records to "enhance the consistency and reliability"—particularly related to diabetes and coronary care.

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