Medicare..Can Physicians Save Move and Improve Care?

Anna Wilde Mathews, a blogger for the Wall Street Journal tackles a tough issue which is the subject of constant buzz in the healthcare community..Medicare reform. It seems a group of doctors participated in a pilot program run by the Centers for Medicare and Medicaid Saving which offered efficient practices incentive payments. Check it out.

"Washington is revving up for a big debate next year over health care — which, realistically, is likely to end up centering around some form of Medicare reform. Everybody wants to somehow save money while also improving care. Proof that trick can be performed consistently in the real world is hard to come by, despite the flurry of concepts and buzzwords being shopped to congressional staffers as the hope for tomorrow.

Some encouraging data are just out from a closely watched demonstration project on incentive payments for doctors being run by the Centers for Medicare and Medicaid Services. The project focuses on 10 physician group practices that can earn extra money by improving efficiency and hitting various quality benchmarks.

The groups scored nearly perfectly on quality measures for diabetes, heart failure and coronary artery disease, with half achieving the targets for all 27 bogeys, and all of the groups meeting at least 25. But only four achieved the CMS efficiency targets and won the extra payments tied to saving the government money and achieving quality standards.

The savings were measured in a typically convoluted way-– the doctor groups got the bonus if the growth of the demonstration participants’ Medicare costs was at least 2% slower than the growth for other beneficiaries in their geographic areas.

John Pilotte, the CMS project director for the pilot, told the Health Blog he felt the savings results were still “very positive,” and better than the first year, when just two groups achieved the goal. Still, he added, “it sort of underscores the challenges and the difficulties in managing care for the Medicare population.”

So what worked? Pilotte and officials from a number of the clinics flagged various things, including those policy-wonk favorites: chronic disease management and coordination of complex cases.

Theodore Praxel, a medical director at Wisconsin’s Marshfield Clinic, one of the four savings-bonus winners, said there was “no single answer,” but he gave a lot of credit to yet another wonkish fave, an electronic medical record that helped track and alert personnel to what services patients needed. He also pointed out that savings from better prevention of health problems can take years to show up."