The Congressional Budget Office’s (CBO) study “Quality Initiatives Undertaken by the Veterans Health Administration (VHA)” published August 2009, discusses the VHA’s experience with not only quality improvement but also with health information technology.
Many of VHA’s quality improvement programs use data from computerized clinical records to track both process and outcome measures, including risk-adjusted mortality and morbidity. These programs have helped VHA recognize problems in specific healthcare facilities as well as to improve performance throughout the agency.
According to the report, one of the major problems that the VA has in dealing with vast amounts of information is the fact that many veterans receive care outside of the VHA system and as a result, the exchange of information is more difficult to achieve. The VHA has made some progress in exchanging patients’ healthcare information with the military health system, but the exchange of data between VHA and private providers still lags behind because of incompatible data structures and a lack of data-sharing agreements.
In addition, when patients are enrolled in both Medicare and VHA they will choose the program for care depending on the type of medical services that they need at the time. For example, few enrollees rely on VHA for outpatient surgery services but a large fraction of those patients seeking outpatient substance abuse treatment turn to the VHA for that type of care.
The study summarizes the VHA programs in place that are designed to improve the quality of care and this includes:
• VistA plays a key role in the agency’s efforts to measure performance and improve quality. Researchers have used clinical data in VistA’s EHR to study the effects of various quality improvement strategies
• An Internal Clinical Peer Review program is in place at each hospital
• An External Peer Review Program extracts data from patient care records in VHA’s clinical systems and then compares the information with evidence-based performance criteria
• A National Surgical Quality Improvement Program is in place that enables risk-adjusted comparisons of surgical outcomes to be made to identify surgical units with unexpectedly high or low rates of morbidity or mortality
• An Inpatient Evaluation Center is designed to improve outcomes in the acute care hospital setting by examining data from EHRs
• A set of programs in the Quality Enhancement Research Initiative aims to put clinical research findings and evidence-based recommendations into clinical practice
• An Evidence-based Synthesis Program systematically reviews published research on medical issues of particular importance to VHA’s user population
To download the report, go to www.cbo.gov then click on recent reports.
Tuesday, September 8, 2009
NIH Awards Grants
Awardees of the “Models of Infectious Disease Agent Study” (MIDAS) grants will receive an estimated $40 million over five years. MIDAS is going to add new research expertise to increase the capacity to simulate disease spread, evaluate different intervention strategies, and use the funding to devise ways to help inform public health officials and policymakers.
Some of the best available tools for studying infectious disease dynamics and interventions are computational models. They incorporate basic information about a disease and the affected communities and then simulate the spread of an infectious agent under any number of conditions.
“Models can’t tell us what will happen but they enable us to explore a range of possibilities for disease containment,” said Jeremy M. Berg, PhD, Director of the National Institute of General Medical Sciences, the NIH component supporting MIDAS. “Since its launch in 2004, the MIDAS research network has been at the forefront of infectious disease modeling efforts, and we hope it continues to serve an important role in preparing for possible outbreaks.”
With a probable resurgence of H1N1, University of Pittsburgh researchers have received $13.4 million from the MIDAS program to establish a “Center of Excellence in Modeling of Infectious Diseases” to be led by Donald Burke, M.D. at the University of Pittsburgh.
The projects at the Center will work to develop statistical tools to define the features of a pathogen and its spread through a population, track the evolution of infectious diseases over time, put a system in place to effectively implement an intervention, and provide new computational tools to local health officials.
Funding will also go to a “Center of Excellence for Communicable Disease Dynamics” to be led by Marc Lipsitch, PhD, from the Harvard School of Public Health. The core research program will focus on modeling drug resistance and studying seasonal infectious diseases. The team will work with health officials to integrate public health knowledge into the models and vice versa.
Other grant funding went to the University of Chicago where Charles Macal, PhD of Argonne National Laboratory in Illinois will create a dynamic model of MRSA to examine factors contributing to its spread. The Yale University School of Public Health and the University of Texas at Austin will develop new models that will integrate individuals’ perceptions and behaviors regarding flu. The University of Washington and the Fred Hutchinson Cancer Research Center in Seattle will develop models to assess the effectiveness and optimal distribution of a variety of control measures.
In addition to these projects MIDAS scientists have published preliminary findings on the origin, infectiousness and likely spread of the 2009 H1N1 virus.
For more information on MIDAS, go to www.nigms.nih.gov/Initiatives/MIDAS.
Some of the best available tools for studying infectious disease dynamics and interventions are computational models. They incorporate basic information about a disease and the affected communities and then simulate the spread of an infectious agent under any number of conditions.
“Models can’t tell us what will happen but they enable us to explore a range of possibilities for disease containment,” said Jeremy M. Berg, PhD, Director of the National Institute of General Medical Sciences, the NIH component supporting MIDAS. “Since its launch in 2004, the MIDAS research network has been at the forefront of infectious disease modeling efforts, and we hope it continues to serve an important role in preparing for possible outbreaks.”
With a probable resurgence of H1N1, University of Pittsburgh researchers have received $13.4 million from the MIDAS program to establish a “Center of Excellence in Modeling of Infectious Diseases” to be led by Donald Burke, M.D. at the University of Pittsburgh.
The projects at the Center will work to develop statistical tools to define the features of a pathogen and its spread through a population, track the evolution of infectious diseases over time, put a system in place to effectively implement an intervention, and provide new computational tools to local health officials.
Funding will also go to a “Center of Excellence for Communicable Disease Dynamics” to be led by Marc Lipsitch, PhD, from the Harvard School of Public Health. The core research program will focus on modeling drug resistance and studying seasonal infectious diseases. The team will work with health officials to integrate public health knowledge into the models and vice versa.
Other grant funding went to the University of Chicago where Charles Macal, PhD of Argonne National Laboratory in Illinois will create a dynamic model of MRSA to examine factors contributing to its spread. The Yale University School of Public Health and the University of Texas at Austin will develop new models that will integrate individuals’ perceptions and behaviors regarding flu. The University of Washington and the Fred Hutchinson Cancer Research Center in Seattle will develop models to assess the effectiveness and optimal distribution of a variety of control measures.
In addition to these projects MIDAS scientists have published preliminary findings on the origin, infectiousness and likely spread of the 2009 H1N1 virus.
For more information on MIDAS, go to www.nigms.nih.gov/Initiatives/MIDAS.
AHRQ to Publish FOA
AHRQ's Center for Primary Care, Prevention, and Clinical Partnerships announced plans on September 1, 2009 to publish a Funding Opportunity Announcement (FOA). The program is looking for community-based research on using communication and information focused technologies to help provide health related services to older adults.
This initiative to be done over five years has three broad strategic themes:
• Use IT to help extend independence and functioning and also to reduce unnecessary healthcare use by older adults
• Use IT to place the individual and families at the center of expanded and more efficient service delivery networks
• Develop innovative approaches to translate evidence generated in the first two thematic areas into practice
The goal is to develop tools, conduct demonstration projects, provide for educational program development and implementation, and evaluate and disseminate the results. The idea is for the cooperative agreement to support a broad integrated, multidisciplinary, multi-project health services research program and bring together experienced teams and new researchers.
The FOA is expected to be published by the end of calendar year 2009. AHRQ is unable to provide additional specific information on its content until the FOA is published. General inquiries can be emailed to Angela Lavanderos, Angela.Lavanderos@ahrq.hhs.gov at the Center for Primary Care, Prevention, and Clinical Partnerships.
This initiative to be done over five years has three broad strategic themes:
• Use IT to help extend independence and functioning and also to reduce unnecessary healthcare use by older adults
• Use IT to place the individual and families at the center of expanded and more efficient service delivery networks
• Develop innovative approaches to translate evidence generated in the first two thematic areas into practice
The goal is to develop tools, conduct demonstration projects, provide for educational program development and implementation, and evaluate and disseminate the results. The idea is for the cooperative agreement to support a broad integrated, multidisciplinary, multi-project health services research program and bring together experienced teams and new researchers.
The FOA is expected to be published by the end of calendar year 2009. AHRQ is unable to provide additional specific information on its content until the FOA is published. General inquiries can be emailed to Angela Lavanderos, Angela.Lavanderos@ahrq.hhs.gov at the Center for Primary Care, Prevention, and Clinical Partnerships.
DOD Seeks Proposals
The Defense Medical Research and Development Program (DMRDP) called the Applied Research and Advanced Technology Development will offer 100 awards with funding of $97 million in FY 2010. These first time awards are going to support research designed to advance state-of-the-art solutions for medical care emphasizing treatments for PTSD, TBI, prosthetics, restoration of eye sight and advanced eye care, plus other conditions directly related to the injuries service members receive on the battlefield.
Specifically, DMRDP is seeking new products, pharmacologic agents, behavioral and rehabilitation interventions, diagnostic and therapeutic devices, clinical guidance, and medical information and training systems and/or emerging approaches and technologies. The goal is to yield potential health products, approaches or technologies ready for human testing.
For more information, go to http://www.grants.gov/ to see FOA (W81xWH-09-DMRDP-ARATDA) announced on August 17th. The Pre-Application deadline is September 25, 2009, invitation to submit an application is November 9, 2009, and the closing date for applications is December 18, 2009.
Specifically, DMRDP is seeking new products, pharmacologic agents, behavioral and rehabilitation interventions, diagnostic and therapeutic devices, clinical guidance, and medical information and training systems and/or emerging approaches and technologies. The goal is to yield potential health products, approaches or technologies ready for human testing.
For more information, go to http://www.grants.gov/ to see FOA (W81xWH-09-DMRDP-ARATDA) announced on August 17th. The Pre-Application deadline is September 25, 2009, invitation to submit an application is November 9, 2009, and the closing date for applications is December 18, 2009.
Wednesday, September 2, 2009
Chronic Diseases Worldwide
“Chronic diseases affect everyone, everywhere,” says Dr. Roger I. Glass, Director of NIH’s Fogarty International Center. The Center is partnering with NIH institutes and others to apply knowledge about cancer, cardiovascular disease, lung disease, and diabetes to help in low and middle income countries.
In June, the Fogarty became a founding member of the Global Alliance for Chronic Diseases (GACD) to collaborate with national health agencies in some of the biggest countries in the world. The GACD comprises the six world agencies that supply about 80 percent of all public research funding in the world.
The Alliance is represented by National Heart Lung Blood Institute, Fogarty Center, Australia’s National Health Medical Research Council, Canadian Institutes of Health Research, and China’s Ministry of Health in association with the Chinese Academy of Medical Sciences, the Indian Council of Medical Research, and the United Kingdom’s Medical Research Council. Other funders including philanthropies will be invited to join in the future and the GACD will consider the WHO 2008-2013 action plan for setting priorities to combat chronic diseases.
The Global Alliance’s priorities are to do large-scale international clinical trials of drugs for preventing heart disease, perform public health measures to control obesity, and develop control measures for chronic obstructive airways disease.
Glass explains. “To make real progress it is going to take international collaboration to prevent and treat diseases in developing countries while at the same time, we need to learn how others are addressing the diseases that we have at home.”
The Center is also making initial grants in its “Millennium Promise Awards” program to train researchers in chronic diseases. The funding for the first awards made in the program will study chronic diseases and will train researchers in Asia, Africa, Latin America, and the Middle East.
Seven awards totaling $7.3 million over five years will enable local scientists and institutions to develop long term training programs to deal with the looming crises in the development of chronic diseases. In addition, two planning grants will provide $108.000 for two years.
Each project will be a partnership between U.S universities and with institutions in the countries where training occurs. The U.S. universities include Vanderbilt University, Yale University, University of Texas Health Sciences Center San Antonio, University of Pittsburgh, Mount Sinai School of Medicine New York, University of Michigan, and Emory University.
The National Heart, Lung, and Blood Institute (NHLBI) commissioned an Institute of Medicine report on cardiovascular disease in developing countries. Also, to deal with worldwide chronic diseases, the NHLBI has just awarded contracts worth more than $34 million to set up chronic diseases training networks in nine countries to be led by a research institution and paired with an academic institution in the country.
NHLBI will fund centers in Bangladesh, China, Guatemala, India, and South Africa with three additional centers in Argentina, Kenya, and Peru. United Health Group’s Chronic Disease Initiative supports the centers and two centers at the U.S. Mexico border and in Tunisia. The centers will do research tailored to the local or regional needs to reduce the burden of chronic diseases including heart disease, heart failure, stroke, diabetes, and COPD. Related risk factors such as high blood pressure, high cholesterol, obesity, and environmental exposures that contribute to COPD will also be emphasized.
“By developing infrastructures for research and training, the centers will apply their considerable expertise to enhance local capacity to conduct population-based or clinical research to monitor, prevent, or control chronic cardiovascular and lung diseases,”, said Dr. Cristina Rabadan-Diehl, Director for the NHLBI program.
In June, the Fogarty became a founding member of the Global Alliance for Chronic Diseases (GACD) to collaborate with national health agencies in some of the biggest countries in the world. The GACD comprises the six world agencies that supply about 80 percent of all public research funding in the world.
The Alliance is represented by National Heart Lung Blood Institute, Fogarty Center, Australia’s National Health Medical Research Council, Canadian Institutes of Health Research, and China’s Ministry of Health in association with the Chinese Academy of Medical Sciences, the Indian Council of Medical Research, and the United Kingdom’s Medical Research Council. Other funders including philanthropies will be invited to join in the future and the GACD will consider the WHO 2008-2013 action plan for setting priorities to combat chronic diseases.
The Global Alliance’s priorities are to do large-scale international clinical trials of drugs for preventing heart disease, perform public health measures to control obesity, and develop control measures for chronic obstructive airways disease.
Glass explains. “To make real progress it is going to take international collaboration to prevent and treat diseases in developing countries while at the same time, we need to learn how others are addressing the diseases that we have at home.”
The Center is also making initial grants in its “Millennium Promise Awards” program to train researchers in chronic diseases. The funding for the first awards made in the program will study chronic diseases and will train researchers in Asia, Africa, Latin America, and the Middle East.
Seven awards totaling $7.3 million over five years will enable local scientists and institutions to develop long term training programs to deal with the looming crises in the development of chronic diseases. In addition, two planning grants will provide $108.000 for two years.
Each project will be a partnership between U.S universities and with institutions in the countries where training occurs. The U.S. universities include Vanderbilt University, Yale University, University of Texas Health Sciences Center San Antonio, University of Pittsburgh, Mount Sinai School of Medicine New York, University of Michigan, and Emory University.
The National Heart, Lung, and Blood Institute (NHLBI) commissioned an Institute of Medicine report on cardiovascular disease in developing countries. Also, to deal with worldwide chronic diseases, the NHLBI has just awarded contracts worth more than $34 million to set up chronic diseases training networks in nine countries to be led by a research institution and paired with an academic institution in the country.
NHLBI will fund centers in Bangladesh, China, Guatemala, India, and South Africa with three additional centers in Argentina, Kenya, and Peru. United Health Group’s Chronic Disease Initiative supports the centers and two centers at the U.S. Mexico border and in Tunisia. The centers will do research tailored to the local or regional needs to reduce the burden of chronic diseases including heart disease, heart failure, stroke, diabetes, and COPD. Related risk factors such as high blood pressure, high cholesterol, obesity, and environmental exposures that contribute to COPD will also be emphasized.
“By developing infrastructures for research and training, the centers will apply their considerable expertise to enhance local capacity to conduct population-based or clinical research to monitor, prevent, or control chronic cardiovascular and lung diseases,”, said Dr. Cristina Rabadan-Diehl, Director for the NHLBI program.
NJ Seeks HIE Applications
The State of New Jersey has released a Request for Applications seeking innovative health information exchange projects. The State through the NJ Health Information Technology Commission and the Office of e-HIT in the Department of Banking and Insurance is currently assembling a State plan for HIT.
The state is looking for projects in the state that hold the promise for establishing a more effective efficient, sustainable, and interoperable exchange of clinically useful data across healthcare provider organizations, cities, and regions.
HHS has made available $564 million to the states for HIEs with each state receiving between $4 and $40 million based on a formula that has yet to be fully released. The state will receive the funding from the Office of the National Coordinator for HIT with information on the funding to be announced on or about December 15, 2009.
A sizable portion of that funding will go to local and regional health information exchanges to promote the exchanges. Once these exchanges are established, the state is going to integrate them with other sources of healthcare data into a secure, statewide health information exchange.
Sustainability has been a major challenge for regional HIEs nationwide. When submitting an application, a detailed and viable plan for financial and operational sustainability for the grant period and beyond that period of time is required. Revenue sources need to be included for future annual costs for hardware, software, licenses, and staff support. The state understands that not all exchange projects will be fully self-sustaining beyond the life of the grants from ONC.
The Request for Applications must be submitted to the State by September 25th. At that point, the Request for Applications received will possibly be incorporated into the state’s application for funding to be submitted to HHS due on October 16th.
For more information, go to http://nj.gov/recovery/grant or contact the State of NJ Department of Health and Senior Services at 609-984-7160.
The state is looking for projects in the state that hold the promise for establishing a more effective efficient, sustainable, and interoperable exchange of clinically useful data across healthcare provider organizations, cities, and regions.
HHS has made available $564 million to the states for HIEs with each state receiving between $4 and $40 million based on a formula that has yet to be fully released. The state will receive the funding from the Office of the National Coordinator for HIT with information on the funding to be announced on or about December 15, 2009.
A sizable portion of that funding will go to local and regional health information exchanges to promote the exchanges. Once these exchanges are established, the state is going to integrate them with other sources of healthcare data into a secure, statewide health information exchange.
Sustainability has been a major challenge for regional HIEs nationwide. When submitting an application, a detailed and viable plan for financial and operational sustainability for the grant period and beyond that period of time is required. Revenue sources need to be included for future annual costs for hardware, software, licenses, and staff support. The state understands that not all exchange projects will be fully self-sustaining beyond the life of the grants from ONC.
The Request for Applications must be submitted to the State by September 25th. At that point, the Request for Applications received will possibly be incorporated into the state’s application for funding to be submitted to HHS due on October 16th.
For more information, go to http://nj.gov/recovery/grant or contact the State of NJ Department of Health and Senior Services at 609-984-7160.
CMS Reports on Demos
The Nursing Home Value-Based Purchasing Demonstration offers financial incentives to nursing homes that meet certain conditions for providing high quality care. The demonstration is open to free-standing and hospital-based facilities with financial rewards going to those facilities that improve or deliver quality care, achieve good outcomes, and avoid unnecessary hospitalizations.
CMS will conduct the demonstration in 79 nursing homes in New York, 62 in Wisconsin and 41 in Arizona. Each of these states assisted in the recruitment process by encouraging facilities to apply to CMS. The demonstration will run from July 2009 through June 2012.
The Physician Hospital Collaboration Demonstration that began July 2009 is evaluating whether gainsharing leads to improvements in quality and efficiency. The demonstration provides an opportunity for hospitals and physicians to join forces to improve quality, efficiency, improve the use of inpatient resources, and to achieve cost reductions.
The demonstration is administered by the New Jersey Hospital Association and has twelve hospitals participating. The program tracks patients beyond a hospital episode to determine the impact of hospital-physician collaborations on preventing short and longer term complications and to determine whether services are duplicated.
The Medical Hospital Gainsharing Demonstration began in October 2008. This demonstration is currently at two sites, Beth Israel Medical Center in New York City, and Charleston Area Medical Center in West Virginia. Under this demonstration, CMS will evaluate whether gainsharing leads to short-term improvements in quality and efficiency during the inpatient stay and immediately following discharge.
According to CMS, the Hospital Quality Incentive Demonstration (HQID) entering its fifth year shows continued quality improvement among participating hospitals. The HQID is sponsored by Medicare in partnership with Premier, Inc., a national hospital quality measurement organization. The demonstration which began in 2003 with hospitals in 38 states was designed to test payment incentives under Medicare to see if they would improve the safety, quality and efficiency of inpatient services by linking incentives to improved quality.
Participants raised overall quality by an average of one percentage point over four years, based on their performance on more than 30 nationally standardized and widely accepted care measures for patients in five clinical areas such as heart attack, coronary bypass graft, heart failure, pneumonia, and hip and knee replacements.
CMS is awarding incentive payments totaling $12 million in year four to 225 hospitals for top performance, top improvements and overall attainment in the five clinical areas. Through the first four years, CMS awarded more than $36.6 million to top performers. After the initial three years of the demonstration, CMS extended the project for three additional years to test new incentive models and ways to improve patient care.
Physician practices participating in the Physician Group Practice (PGP) Demonstration continue to improve quality for patients with chronic illnesses or requiring preventive care. All ten of the physician groups participating in the demonstration achieved benchmark performance on at least 28 of the 32 measures reported in year three of the demonstration. Two groups Geisinger Clinic in Danville PA and Park Nicollet Health Services in St. Louis Park, MN achieved benchmark performance on all 32 performance measures.
Under the PGP demonstration, physician groups earn incentive payments based on the quality of care they provide and the estimated savings they generate in Medicare expenditures for the patient population they serve. As a result of their efforts, five physician groups will receive performance payments totaling $25.3 million as part of their share of $32.3 million of savings generated for the Medicare Trust Funds in year three.
Over the first three years, the physician groups increased their quality scores an average of 10 percentage points on ten diabetes measures, 11 points on ten congestive heart failure measures, 6 points on seven coronary artery disease measures, 10 points on two cancer screening measures, and one percentage point on three hypertension measures.
More than 560 small and solo physician practices participating in the Medicare Care Management Performance (MCMP) Demonstration have been rewarded for providing high quality care in the delivery of preventive care and care for patients with chronic illnesses. The goal of the demonstration is to promote the use of health information technology to help beneficiaries with chronic conditions.
Doctors in small to medium sized practices who meet clinical performance standards on each measure are eligible to receive financial rewards under the MCMP demonstration. The demonstration also provides an additional bonus to practices that report the data using an EHR certified by CCHIT. Twenty three percent of practices were able to submit at least some of the measures from a certified EHR.
In the first year of the MCMP demonstration, almost all of the 610 participating small and solo physician practices were rewarded for performance on 26 quality measures. CMS is awarding $7.5 million in incentive payments to over 560 practices in California, Arkansas, Massachusetts, and Utah. The average payment per practice is $14,000 but some practices earned as much as $62,500. Last year, CMS paid out over $1.5 million for incentives for reporting baseline quality measures.
For additional information, go to www.cms.hhs.gov/DemoProjectsEvalRepts/MD/list.asp.
CMS will conduct the demonstration in 79 nursing homes in New York, 62 in Wisconsin and 41 in Arizona. Each of these states assisted in the recruitment process by encouraging facilities to apply to CMS. The demonstration will run from July 2009 through June 2012.
The Physician Hospital Collaboration Demonstration that began July 2009 is evaluating whether gainsharing leads to improvements in quality and efficiency. The demonstration provides an opportunity for hospitals and physicians to join forces to improve quality, efficiency, improve the use of inpatient resources, and to achieve cost reductions.
The demonstration is administered by the New Jersey Hospital Association and has twelve hospitals participating. The program tracks patients beyond a hospital episode to determine the impact of hospital-physician collaborations on preventing short and longer term complications and to determine whether services are duplicated.
The Medical Hospital Gainsharing Demonstration began in October 2008. This demonstration is currently at two sites, Beth Israel Medical Center in New York City, and Charleston Area Medical Center in West Virginia. Under this demonstration, CMS will evaluate whether gainsharing leads to short-term improvements in quality and efficiency during the inpatient stay and immediately following discharge.
According to CMS, the Hospital Quality Incentive Demonstration (HQID) entering its fifth year shows continued quality improvement among participating hospitals. The HQID is sponsored by Medicare in partnership with Premier, Inc., a national hospital quality measurement organization. The demonstration which began in 2003 with hospitals in 38 states was designed to test payment incentives under Medicare to see if they would improve the safety, quality and efficiency of inpatient services by linking incentives to improved quality.
Participants raised overall quality by an average of one percentage point over four years, based on their performance on more than 30 nationally standardized and widely accepted care measures for patients in five clinical areas such as heart attack, coronary bypass graft, heart failure, pneumonia, and hip and knee replacements.
CMS is awarding incentive payments totaling $12 million in year four to 225 hospitals for top performance, top improvements and overall attainment in the five clinical areas. Through the first four years, CMS awarded more than $36.6 million to top performers. After the initial three years of the demonstration, CMS extended the project for three additional years to test new incentive models and ways to improve patient care.
Physician practices participating in the Physician Group Practice (PGP) Demonstration continue to improve quality for patients with chronic illnesses or requiring preventive care. All ten of the physician groups participating in the demonstration achieved benchmark performance on at least 28 of the 32 measures reported in year three of the demonstration. Two groups Geisinger Clinic in Danville PA and Park Nicollet Health Services in St. Louis Park, MN achieved benchmark performance on all 32 performance measures.
Under the PGP demonstration, physician groups earn incentive payments based on the quality of care they provide and the estimated savings they generate in Medicare expenditures for the patient population they serve. As a result of their efforts, five physician groups will receive performance payments totaling $25.3 million as part of their share of $32.3 million of savings generated for the Medicare Trust Funds in year three.
Over the first three years, the physician groups increased their quality scores an average of 10 percentage points on ten diabetes measures, 11 points on ten congestive heart failure measures, 6 points on seven coronary artery disease measures, 10 points on two cancer screening measures, and one percentage point on three hypertension measures.
More than 560 small and solo physician practices participating in the Medicare Care Management Performance (MCMP) Demonstration have been rewarded for providing high quality care in the delivery of preventive care and care for patients with chronic illnesses. The goal of the demonstration is to promote the use of health information technology to help beneficiaries with chronic conditions.
Doctors in small to medium sized practices who meet clinical performance standards on each measure are eligible to receive financial rewards under the MCMP demonstration. The demonstration also provides an additional bonus to practices that report the data using an EHR certified by CCHIT. Twenty three percent of practices were able to submit at least some of the measures from a certified EHR.
In the first year of the MCMP demonstration, almost all of the 610 participating small and solo physician practices were rewarded for performance on 26 quality measures. CMS is awarding $7.5 million in incentive payments to over 560 practices in California, Arkansas, Massachusetts, and Utah. The average payment per practice is $14,000 but some practices earned as much as $62,500. Last year, CMS paid out over $1.5 million for incentives for reporting baseline quality measures.
For additional information, go to www.cms.hhs.gov/DemoProjectsEvalRepts/MD/list.asp.
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