| 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, www.cms.gov.
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