Large medical group practices have proven they can adjust to respond to a variety of quality and cost-containment incentives, in one of the first tests of a pay-for-performance approach.
“Medicare Physician Group Practices: Innovations in Quality and Efficiency,” issued by The Commonwealth Fund last month, gave generally positive marks to the first large-scale demonstration project of a pay-for-performance approach.
The group practices “have used the demonstration as a vehicle for expanding data systems, care management programs, coordination of care efforts and other interventions that are not directly reimbursed in fee-for-service payments,” the report said.
The Centers for Medicare and Medicaid Services developed the demonstration project, which included 10 large group practices spanning four census regions. Each of the practices has at least 200 physicians.
In addition to improving care management and pallative and hospice care, the practices used the demonstration project to influence physicians to improve quality of care, such as by modifying work processes. They also encouraged physicians to consider the health of a panel of patients rather than just individuals and provide feedback reports to improve care coordination and quality.
The group practices also stepped up their use of information technology to track patients and their care, improve reports to physicians and provide automated reminders.
The test showed that physician groups respond well to direct financial incentives for better-than-expected performance, the Commonwealth Fund report said.
“It tests whether a provider-based approach emphasizing ‘the carrot’ rather than ‘the stick’ will prove effective in enhancing the quality and efficiency of care received by Medicare beneficiaries,” the report said. n