THE MEDICARE PHYSICIAN GROUP PRACTICE DEMONSTRATION: LESSONS LEARNED ON IMPROVING QUALITY AND EFFICIENCY IN HEALTH CARE

Abstract

In April 2005, the Centers for Medicare and Medicaid Services (CMS) initiated the Physician Group Practice demonstration, which offers 10 large practices the opportunity to earn performance payments for improving the quality and cost-efficiency of health care delivered to Medicare fee-for-service beneficiaries. This report is based on the proceedings of a 2006 site conference held in Baltimore and cosponsored by The Commonwealth Fund, CMS, and the Agency for Healthcare Research and Quality. The meeting provided a forum for PGPs to: 1) explore specific care management models, including methods for implementation and assessment of effectiveness; 2) accelerate learning across PGPs through information sharing; and 3) harvest knowledge and develop a plan for case studies and descriptive reports on successful care management models. A number of promising practice changes were discussed, such as increasing patient engagement, expanding care management, improving care transitions, and expanding non-physician roles. Support for this research was provided by The Commonwealth Fund and by the Centers for Medicare and Medicaid Services (CMS) under contract No. 500-00-0024, T.O. No. 13. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff, or the views and policies of CMS. This and other Fund publications are available online at www.commonwealthfund.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 1094.