Medicare’s value-based purchasing (VBP) initiative has improved performance in targeted quality measures among participating hospitals, physician groups, and individual and small group physician practices, according to CMS. Its VBP initiative is designed to tie Medicare payments to performance on quality and efficiency as part of the agency’s effort to transform Medicare into an active purchaser of higher quality, more efficient health care.
Hospital quality
Medicare sponsors the hospital quality incentive demonstration (HQID) together with Premier, Inc., a national hospital quality measurement organization. The demonstration, which began in 2003 with hospitals in 38 states, was designed to test whether linking Medicare payment incentives to quality would improve the safety, quality, and efficiency of inpatient services.
HQID participants raised overall quality by an average of 17 percentage points over four years, based on their performance on more than 30 nationally standardized and widely accepted care measures for patients in five clinical areas – heart attack, coronary bypass graft, heart failure, pneumonia, and hip and knee replacements.
Physician group practices
Under the physician group practice demonstration (PGPD), physician groups earn incentive payments based on the quality of care that they provide and the estimated savings they generate in Medicare expenditures for the patient population that they serve. As a result of their efforts to reduce the growth rate in Medicare expenditures, five physician groups will receive performance payments totaling $25.3 million as part of their share of $32.3 million of savings generated for the Medicare trust funds in performance year three.
All ten of the physician groups participating in the PGPD achieved benchmark performance on at least 28 of the 32 measures reported in year three of the demonstration. Two groups–Geisinger Clinic in Danville, Pa., and Park Nicollet Health Services in St. Louis Park, Minn.–achieved benchmark performance on all 32 performance measures.
Over the first three years of the demonstration, the physician groups increased their quality scores an average of ten percentage points on ten diabetes measures, 11 points on ten congestive heart failure measures, six percentage points on seven coronary artery disease measures, ten percentage points on two cancer screening measures, and one percentage point on three hypertension measures.
Small and solo practices
Small and solo physician practices participating in the Medicare care management performance demonstration (MCMPD) received incentives to promote the use of health information technology to improve the quality of care for beneficiaries with chronic conditions. In the first year of the MCMPD, nearly all of the 610 participating small and solo physician practices are being rewarded for performance on 26 quality measures.
CMS is awarding approximately $7.5 million in incentive payments to more than 560 practices in California, Arkansas, Massachusetts, and Utah. The average payment per practice is $14,000, but some practices earned as much as $62,500. Last year, CMS paid more than $1.5 million in incentives for reporting baseline quality measures.
CCH Chicago Bureau, Aug. 26, 2009
For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.
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