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Home / News & IndustryManaged Care Insight and Analysis
Updated: December 22, 2009
9 Physician Groups And Clinic Improve Quality Of Care In CMS Demonstration Program

Participating physician groups have increased their quality scores an average of 10 percentage points on diabetes measures, 11 percentage points on congestive heart failure measures, 6 percentage points on coronary artery disease measures, 10 percentage points on cancer screening measures, and 1 percentage point on hypertension measures, according to a report on the results of the first three years of a demonstration program sponsored by The Centers for Medicare and Medicaid Services (CMS).

A direct result of the improvements in quality is that the Dartmouth-Hitchcock Clinic, along with four other physician groups, will receive performance payments totaling $25.3 million as part of their share of $32.3 million of savings generated for the Medicare Trust Funds in Performance Year Three, said CMS.

Under the demonstration, CMS said physician groups are held accountable for the quality of care and the growth in Medicare expenditures for the patient population they serve. "In turn, the physician groups have the flexibility to redesign care to improve quality and reduce Medicare expenditure growth," said CMS.

CMS reported that along with Dartmouth-Hitchcock Clinic, part of Dartmouth-Hitchcock Medical Center, nine other physician groups participating in the innovative, CMS-sponsored Physician Group Practice Demonstration, improved performance on the delivery of preventive care, and care for patients with chronic illness while generating millions of dollars in savings for the Medicare program through quality improvement and better coordination of care.

The demonstration program provides incentives for better coordination of Medicare Part A and Part B services, promotes the investment in care management programs and redesigned care processes, and rewards physicians for improving health outcomes, said CMS.

According the program results, all of the physician groups achieved benchmark performance on at least 28 of the 32 measures reported in year three of the program.

"At Dartmouth-Hitchcock, this initiative fits right into the organization’s mission and its vision to achieve the healthiest population possible," said Dr. Barbara Walters, Dartmouth-Hitchcock’s senior medical director.

"The program has challenged us to find ways to innovate in the way we deliver care to all of our patients by taking a systems approach to improving the efficiency and the quality of our care," said Walters.

Another key to the program’s success, she added, was that it "allowed us the flexibility to develop systems that worked best for us, and not trying to impose a one-size-fits-all methodology."

Performance Year Three was the first year that all 32 measures were in effect for the demonstration, officials said. The measures focus on diabetes, congestive heart failure, coronary artery disease, hypertension, and cancer screening. The measures are consistent with clinical practice and high qualitycare and have support from the physician community, CMS said.

Given the acceptability of the measures and the reporting methodology, CMS recently announced that other large physician groups may use this reporting methodology and similar measures to participate in the Physician Quality Reporting Initiative starting next year.

Physician groups have focused on redesigning care to improve quality and reign in Medicare expenditure growth, the agency said. Their efforts have included "better coordinating care for patients transitioning between care settings, proactively reaching out to patients with chronic illness and more aggressively monitoring them between physician visits, and identifying patients early so that end-of-life care may be better coordinated."

Health information technology plays a critical role by providing practitioners in the group with more complete clinical information about the patient that can be used to monitor patients between visits, identify gaps in care, and better coordinate services.

Addresses: Centers for Medicare and Medicaid Services, 7500 Security Blvd., Baltimore, MD 21244; (877) 267-2323,

  This article was taken from:
Pay-for-Performance Reporter

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