WASHINGTON – Federal pay-for-performance demonstrations continue to back what the Centers for Medicare and Medicaid Services is calling a strong case for changing the way hospitals and doctors are paid under Medicare.
On Monday, CMS announced results from three of its demonstrations – one for large physician practices, one for small and solo physician practices and one for hospitals, all with positive outcomes on increasing quality of care and lowering costs. CMS officials said the agency plans to continue building on those efforts and has recently launched the Nursing Home Value-Based Purchasing Demonstration, the Medicare Hospital Gainsharing Demonstration and the Physician Hospital Collaboration Demonstration.
According to CMS, the nursing home demonstration will reward facilities that can improve or deliver high quality care in the areas of staffing, resident outcomes, avoidable hospitalizations and reductions in deficiency citations. The gainsharing and physician-hospital collaboration programs will evaluate whether gainsharing leads to improvements in quality and efficiency.
New results for the fourth year of the CMS/Premier healthcare alliance Hospital Quality Incentive Demonstration show participating hospitals raised their overall quality by an average of 17.2 percent. The pilot was based on 30 nationally standardized and widely accepted care measures in the areas of heart attack, coronary bypass graft, heart failure, pneumonia and hip and knee replacements. Premier analysts estimated the demonstration saved the lives of some 4,700 heart attack patients in four years.
"We continue to be encouraged by the progress of our ongoing programs that test value-based purchasing across a variety of healthcare services," said Charlene Frizzera, CMS' acting administrator.
Jonathan Blum, director of the CMS Center for Medicare Management and acting director of the Center for Health Plan Choices, said what the agency learns from the various Medicare demonstrations will help achieve the administration's goals of paying for high quality and efficient healthcare in America. The results come as President Barack Obama pushes for Medicare payment reform as part of a comprehensive health reform package.
Physician practices participating in the Physician Group Practice (PGP) Demonstration continue to improve quality for patients with chronic illnesses or requiring preventive care, CMS officials reported.
More than 560 small and solo physician practices participating in the Medicare Care Management Performance (MCMP) Demonstration are currently being rewarded for providing high quality care in the delivery of preventive care and care for patients with chronic illnesses, according to CMS.
