decisionhealth Newsletters, Part B News - 2007 Issue 7 (July)
PGP Demo: EHR, case management make PGP demo successful
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Article Overview
This article covers early findings from the Medicare Physician Group Practice Demonstration and explains why participating large group practices reported quality improvements. It is relevant to practice leaders, care management teams, health information technology stakeholders, and coding/billing professionals who track Medicare demonstration activity and care coordination trends. The piece discusses the demonstration structure, the quality domains addressed over multiple years, the types of organizational investments practices made, and the general financial and operational implications reported by participants and CMS.
Why This Topic Matters
It helps readers understand how Medicare demonstration programs can influence practice operations, care coordination models, and quality-improvement investments. The article is useful for organizations evaluating similar efforts, including the use of electronic health records and staffing approaches to support follow-up and chronic disease management.
Article Sections
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Early results from the Medicare Physician Group Practice Demonstration
Introduces the demonstration, summarizes the first-year quality results, and identifies participating group practices that achieved notable outcomes.
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Financial outcomes and participant perspectives
Discusses bonus payments, savings results, and comments from participating organizations about the motivations for joining the demonstration.
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Later-year focus areas and practice improvement strategies
Describes the broader care areas targeted in later phases of the demonstration and the operational approaches practices used to improve care delivery.
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Investment, cost, and coverage concerns
Reviews the financial investments practices made to support their efforts and notes participant concerns about costs, returns, and services not covered by Medicare.
What You Will Learn
- How a Medicare demonstration program was structured around quality improvement and shared savings.
- What kinds of operational and technology investments practices used to support care management.
- Which broad care areas were emphasized across different phases of the demonstration.
- Why participant experiences with costs and returns varied across organizations.
Who Should Read This
- Physician practice administrators
- Care management leaders
- Health information technology teams
- Medical coders and billing staff
- Healthcare executives
- Quality improvement professionals
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