ANN ARBOR, Mich., Aug. 14 /PRNewswire-USNewswire/ -- Older patients with heart disease and diabetes are getting better treatment than ever at the University of Michigan Health System -- even while U-M's care for Medicare patients is costing less, a new report shows. The data come from the second year of a national project undertaken by 10 large physician groups, including the U-M Faculty Group Practice.
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The results were announced today in Washington, D.C., by the Centers for Medicare and Medicaid Services. CMS oversees the Medicare system and launched the project to encourage innovation, efficiency and the development of quality improvement efforts that might be used by doctors and hospitals nationwide.
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U-M was one of only two participating groups that achieved both of the project's aims: to provide the highest-quality care on all 27 of the project's heart and diabetes measures, and to contain health care spending growth for all traditional Medicare patients, including those with costly chronic illnesses.
As a result, U-M will get to keep $1.24 million of the funding that Medicare would have otherwise spent on the care of U-M patients in that year, and will also earn more than $460,000 as an incentive for providing high-quality care.
This is the second year in a row that U-M has achieved both sizable savings and high scores on health care quality benchmarks as part of the project, even as the project was expanded to include patients with heart failure and coronary artery disease. Two more years worth of data remain to be collected and analyzed.
The U-M Faculty Group Practice, part of the U-M Medical School, includes all 1,500 U-M faculty physicians who care for patients at the three U-M hospitals and 40 U-M health centers. Many of the programs and innovations that U-M has put in place for this project involve not only physicians but nurses, social workers, care managers and others who are involved in the care of Medicare patients at all U-M facilities.
The report is based on data from approximately 20,000 Medicare participants who received nearly all their care at U-M during the year that began April 1, 2006. It does not include those who were enrolled in a Medicare Advantage plan offered by a private health plan, nor Medicare participants who received only limited care at U-M. But the improvements made for the project are helping many other patients.
"The U-M Faculty Group Practice funded this project because we thought it was the right way to care for our patients," says David Spahlinger, M.D., senior associate dean for clinical affairs. "We felt confident we could improve quality but we were uncertain if our interventions would save money. I believe that this project will provide many lessons for policy makers as the nation confronts the rising costs of health care."
The project's formal name is the Medicare Physician Group Practice Demonstration. It is Medicare's first Pay for Performance Demonstration Project to work directly with physician groups. It began by focusing on the quality of care of patients with diabetes, but in the second year was expanded to include heart failure and coronary artery disease - both chronic heart conditions that carry a very high risk of emergency hospitalization, and other care, if not managed appropriately.
Because of its participation in this project, U-M is also automatically participating in another Medicare project, the Physician Quality Reporting Initiative or PQRI. In fact, the $460,000 that U-M earned for achieving high-quality care on 27 benchmarks is being paid through PQRI. The dollars U-M earned for saving Medicare money are calculated
