CMS is going out of its way to start showing progress on quality improvement and financial savings, releasing early results from three demonstration programs. The demos, which focus on both physician and hospital groups, are several years old and ongoing, but CMS released partial data that provides "strong evidence that offering providers financial incentives for improving patient care increases quality of care, and can reduce the growth in Medicare expenditures," the agency said in a press release.
"Based on what we have learned so far, we know the health care industry can meet high standards for improving quality of care while saving Medicare money," said CMS Administrator Donald Berwick, MD, in a prepared statement. He acknowledged that the progress so far is "just a start" but should be viewed as a sign that CMS's demos confirm the agency's decision to focus on pay-for-performance reimbursement models.
Here's the breakdown of the three demos:
- The Hospital Quality Incentive Demonstration (HQID) attempts to raise quality in hospitals based on 30 patient care measures
- The Physician Group Practice (PGP) Demonstration attempts to improve preventive and chronic care delivery processes and generate shareable Medicare savings (split between CMS and participating providers)
- The Medicare Care Management Performance (MCMP) Demonstration also attempts to improve the delivery of preventive care and quality of care for patients with chronic illnesses.Hospitals Continue to Improve Quality
HQID
This demo began in 2003 with hospitals in 38 states and resulted in "improved performance across the board" for the participants. CMS will hand out $12 million to 212 hospitals. Hospitals were scored on more than 30 care measures and showed an average of 18% improvement overall.
PGP
Under the PGP demonstration, physician groups earned incentive payments based on quality of care provided and estimated savings to Medicare. Five physician groups will receive performance payments worth $31.7 million -- their share of $38.7 million in total savings to Medicare.
MCMP
More than 500 participating small and solo physician practices are being rewarded based on the results of 26 quality measures. CMS will dole out about $9.5 million in incentive payments to practices in four states. The average payment per practice is $18,100 but some practices earned as much as $62,500.
You can check out CMS's official demo projects site for more details on each of these three programs: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/list.asp.