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Geisinger, Dartmouth-Hitchcock to Continue in CMS PGP Transitions Demo

Geisinger Health System and Dartmouth-Hitchcock are among 10 physician groups that will continue to participate in CMS's Physician Group Practice Transitions Demonstration (PGP TD).

The PGP, a partnership with physician group practices that aims to improve quality and savings in Medicare expenditures, was first implemented five years ago. Physician groups earn incentive payments based on the quality of care they provide and the estimated savings they generate in Medicare expenditures for their patient populations.

The program’s success fueled the new PGP TD, a two-year supplement to the original PGP Demonstration, which began January 1, 2011. The PGP sites all elected to participate in an optional “Leading Quality Group;” participation in this group elicits an additional 10 percent in shared savings. Performance payments will be based on meeting improvement targets and composite quality measures for diabetes, heart failure, coronary artery disease, hypertension and chronic obstructive pulmonary disease.

Under the PGP Demonstration, Geisinger achieved 100 percent on the program’s quality measures. The health system is the only one of the 10 organizations to do so for the last four years of the demonstration. By focusing on improving quality, Geisinger’s costs rose only 1.4 percent, compared to the typical 4 to 6 percent increase observed nationwide.

In the fifth year of the demonstration, seven groups achieved benchmark performance on all 32 performance measures, including Geisinger Health System. The remaining three groups, including Dartmouth-Hitchcock, achieved benchmark performance on at least 30 of the 32 reported measures.

All ten physician groups achieved benchmark performance on heart failure, coronary artery, and preventive care measures. Over the five years of the demonstration, the physician groups also increased their quality scores in the following areas:

  • Diabetes by 11 percent.
  • Heart failure by 12.4 percent.
  • Coronary artery disease by 6 percent.
  • Cancer screening by 9.2 percent.
  • Hypertension by 3.8 percent.

Four of the groups will receive incentive payments of $29.4 million (out of total savings to Medicare of $36.2 million). Over the five years of the demonstration, Medicare has paid $110 million in incentives to seven of the PGP participants.


Source: CMS, August 8, 2011

Health Management Tools for Accountable Care Organizations

This guide examines the building blocks of population health management that drive improvements in healthcare quality, efficiency and reimbursement in ACOs. Learn how CMS Physician Group Practice participant Dartmouth-Hitchcock has developed a competency in population health management that it deploys in ongoing ACO pilots with Medicare and private payors.

Health Management Tools for Accountable Care Organizations is available from the Healthcare Intelligence Network for $149 by visiting our Online Bookstore or by calling toll-free (888) 446-3530.

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IMPORTANT NOTICE: This information is designed to provide accurate and authoritative information on the business of healthcare. It is distributed with the understanding that Healthcare Intelligence Network is not engaged in rendering legal advice. If legal advice is required, the services of a competent professional should be retained.

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