Medicare P4P initiative nets $17M results, better CV care

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Ten large medical group practices across the U.S. have seen a combined cost savings of $16.7 million as a result of a Medicare pay-for-performance (P4P) health IT demonstration project, designed to control healthcare costs and improve quality.

In second-year results reported Aug. 14, the Centers for Medicare & Medicaid Services (CMS) said that the four-year project also delivered $5.8 million back to Medicare and achieved more than 20 percent of the savings by providing better, more coordinated care for the patients at the group practices over the last two years.

All 10 participating physician groups achieved benchmark or target performance on at least 25 out of 27 quality markers for patients with diabetes, coronary artery disease and congestive heart failure.

Five of the physician groups— Forsyth Medical Group in Winston-Salem, N.C.; Geisinger Clinic in Danville, Pa.; Marshfield Clinic in Marshfield, Wis.; St. John’s Health System, Springfield, Mo.; and the University of Michigan Faculty Group Practice in Ann Arbor, Mich.— achieved benchmark quality performance on all 27 quality measures, according to CMS.

The demonstration is one of CMS’ value-based purchasing (VBP) initiatives, designed to drive to transform Medicare from a passive payor to an active purchaser of higher quality, more efficient healthcare.
A related VBP effort is the Physician Quality Reporting Initiative (PQRI), which offers physicians and other healthcare professionals incentive payments for reporting measurement data about the quality of care they provide to Medicare patients.
CMS said it is also developing a Physician VBP Plan for moving from the PQRI pay-for-reporting approach to a performance-based approach. 
The 10 physician groups participating in the P4P demonstration agreed to place their PQRI incentive payments at risk for performance on the 27 quality measures reported under the demonstration. All physician groups received at least 96 percent of their PQRI incentive payments, with five groups earning 100 percent of their incentive payments. A total of $2.9 million in PQRI incentive payments was paid out to the 10 groups under the demonstration, according to the agency.
The groups also improved the quality of care delivered to Medicare beneficiaries on the chronic conditions measured.  Physician groups increased their quality scores an average of 9 percentage points across the diabetes mellitus measures, 11 percentage points across the heart failure measures and 5 percentage points across the coronary artery disease measures.

The other five groups in the P4P project are Billings Clinic in Billings, Mont.; Dartmouth-Hitchcock Clinic in Bedford, N.H.; The Everett Clinic in Everett, Wash.; Middlesex Health System in Middletown, Conn.; and Park Nicollet Health Services in St. Louis Park, Minn.