Researchers have found CMS' Physician Group Practice Demonstration — the precursor trial to accountable care organizations — yielded significant savings, particularly for dual eligibles, according to a study in the Journal of the American Medical Association.
The PGP Demonstration is a CMS experiment that took place at 10 medical groups across the country from 2005 to 2010. Roughly 5,000 physicians and 222,000 Medicare patients were included in the demo, which resembled accountable care organizations in that physicians receive bonus payments if they meet 32 quality measures and lower cost growth compared with local controls. Until now, evidence has linked improved quality care to the demo, but little was known about its affect on costs.
In the study, researchers from the Dartmouth Institute for Health Policy and Clinical Practice analyzed the demo's annual spending per Medicare beneficiary from 2005 through 2009.
The participating medical groups slowed overall annual spending per patient by $114 upon their participation in the demo. The groups also saved an average of $532 per dual eligible patient, a population that comprises 15 percent of Medicaid beneficiaries. Spending on dual eligibles in the demo grew at 60 percent of the rate of the control group.
The demo was also associated with lower medical 30-day readmissions on average across the 10 sites and lower readmissions for both medical and surgical admissions in the dual eligible beneficiaries.
"Our results suggest that the ACO reforms included in the Affordable Care Act, such as the Pioneer and the Medicare Shared Savings Programs, have at least the potential to slow spending growth, particularly for costly patients," the study authors concluded.
Lessons From the Group Practice Demonstration for ACOs: Q&A with University of Michigan's Dr. Caroline Blaum
CMS: 7 Out of 10 Practices in PGP Demonstration Met Benchmarks, 4 Achieved Shared Savings
The PGP Demonstration is a CMS experiment that took place at 10 medical groups across the country from 2005 to 2010. Roughly 5,000 physicians and 222,000 Medicare patients were included in the demo, which resembled accountable care organizations in that physicians receive bonus payments if they meet 32 quality measures and lower cost growth compared with local controls. Until now, evidence has linked improved quality care to the demo, but little was known about its affect on costs.
In the study, researchers from the Dartmouth Institute for Health Policy and Clinical Practice analyzed the demo's annual spending per Medicare beneficiary from 2005 through 2009.
The participating medical groups slowed overall annual spending per patient by $114 upon their participation in the demo. The groups also saved an average of $532 per dual eligible patient, a population that comprises 15 percent of Medicaid beneficiaries. Spending on dual eligibles in the demo grew at 60 percent of the rate of the control group.
The demo was also associated with lower medical 30-day readmissions on average across the 10 sites and lower readmissions for both medical and surgical admissions in the dual eligible beneficiaries.
"Our results suggest that the ACO reforms included in the Affordable Care Act, such as the Pioneer and the Medicare Shared Savings Programs, have at least the potential to slow spending growth, particularly for costly patients," the study authors concluded.
More Articles on the Physician Group Practice Demonstration:
What Results From the Physician Group Practice Demo Really Suggest About ACOsLessons From the Group Practice Demonstration for ACOs: Q&A with University of Michigan's Dr. Caroline Blaum
CMS: 7 Out of 10 Practices in PGP Demonstration Met Benchmarks, 4 Achieved Shared Savings