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Medicare P4P Demo Pays $16.7 Million


All 10 organizations participating in a Medicare physician group practice pay-for-performance demonstration program qualified for incentive payments by meeting certain benchmarks for quality of care. In total, Medicare paid $16.7 million in incentive payments to the organizations during the second year of the demonstration.

The group practices received a total of $2.9 million for meeting at least 25 of 27 performance measures for treating patients with diabetes, coronary artery disease and congestive heart failure.

Five of the practices achieved benchmark quality performance on all 27 measures. They are: Forsyth Medical Group in Winston-Salem, N.C.; Geisinger Clinic in Danville, Pa.; Marshfield (Wis.) Clinic; St. John’s Health System in Springfield, Mo.; and the University of Michigan Faculty Group Practice in Ann Arbor.

Other practices participating in the demonstration and receiving incentive payments are Billings (Mont.) Clinic; Dartmouth-Hitchcock Clinic in Bedford, N.H.; The Everett (Wash.) Clinic; Middlesex Health System in Middletown, Conn.; and Park Nicollet Health Services in St. Louis Park, Minn.

Combined, the group practices increased their quality scores an average of 9% across diabetes measures, 11% across heart failure measures and 5% across coronary artery disease measures. Enhancements to electronic health records systems and patient registries enabled the practices to more easily identify gaps in care and alert appropriate physicians, according to the Centers for Medicare and Medicaid Services.

Four physician groups also earned $13.8 million in additional performance payments for overall improvement in the quality and efficiency of care. They are Dartmouth-Hitchcock, Everett, Marshfield and the University of Michigan.

The program is called the Physician Group Practice Demonstration. It is separate from the Medicare’s Physician Quality Reporting Initiative, which provides incentive payments for collecting and reporting certain quality measures.

Results for the P4P program are for the second year of the demonstration, covering April 1, 2006, through March 31, 2007. The initial three-year program has been extended a year and will run through March 2009.

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