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
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