Commonwealth Fund: Participants in Medicare’s Physician Group Practice (PGP) Demonstration, launched in 2005, are charged with improving the coordination of care for their fee-for-service beneficiaries, investing in administrative and process improvements to increase efficiency, and improving the quality of patient care. Practices earn performance payments based on their success in meeting these goals.
In the new Commonwealth Fund report, The Medicare Physician Group Practice Demonstration: Lessons Learned on Improving Quality and Efficiency in Health Care, Michael Trisolini and colleagues at RTI International report on what the participating practices have learned so far in their efforts to improve quality and efficiency, how they might go about expanding and refining the interventions they have designed, and what the broader implications are for the Medicare program.
The PGP participants have faced challenges, say the authors, including lags in receiving and reporting data, limited reimbursement for non-physician care, and the often substantial upfront investments required for care innovations. But despite these challenges, all the participating groups achieved their performance targets for at least seven of the 10 diabetes quality measures that were the primary focus in the first year.
An evaluation of the demonstration, which is nearing the end of its initial three-year period, is being conducted by the Centers for Medicare and Medicaid Services to assess the PGPs’ interventions and their impact on quality and costs.