Park Nicollet receives Medicare performance bonus
Officials from the Centers for Medicare & Medicaid Services (CMS) informed Park Nicollet Health Services that it has achieved 100% of its quality goals for the third consecutive year as part of its participation in the “Physician Group Practice” (PGP) Demonstration Program. Park Nicollet will also receive a federal bonus payment of nearly $5.7 million for its PGP results.
Park Nicollet CEO David Abelson says the PGP results position Park Nicollet well for upcoming changes in health care. “With federal and state outcomes-based programs coming online in the next 15 to 18 months, this recognition gives Park Nicollet the demonstrated experience necessary to show our patients and partners that we have the skills and the team in place to succeed in today’s challenging health care environment.”
The PGP Demonstration was Medicare’s first physician pay-for-performance initiative that established incentives for quality improvement and cost efficiency at the level of physician group practices. Park Nicollet’s portion of the program involved just under 17,500 Medicare beneficiaries. Quality improvement for that population was evaluated using 32 care quality measures covering five conditions: diabetes, heart failure, coronary artery disease, hypertension and preventive care. Once calculated, CMS then extracted this data to determine if improved quality resulted in fewer avoidable hospital admissions, readmissions and emergency department visits, providing savings for CMS and American taxpayers.
Savings are awarded 50% based on efficiency and 50% based on achieving quality targets. Because Park Nicollet achieved 100% in quality targets for performance year 5, Park Nicollet will receive the full amount of bonus pool funds available. Park Nicollet has now achieved 100% of quality goals for three straight years in the demonstration, although this is the first year that Park Nicollet has received a bonus payment from CMS.
Park Nicollet has provided substantial savings to CMS in the PGP demonstration, including $10 million in Year 5 of the pilot program and $12.3 million since the program began in 2005. “Our results provide compelling evidence that paying for outcomes, rather than volume, helps our patients, helps make health care more affordable and saves money for taxpayers, said Abelson.
List of participating PGP sites:
- Park Nicollet Health Services, St. Louis Park, Minnesota
- Dartmouth-Hitchcock Clinic, Bedford, New Hampshire
- Deaconess Billing Clinic, Billings, Montana
- The Everett Clinic, Everett Washington
- Geisinger Clinic, Danville, Pennsylvania
- The Marshfield Clinic, Marshfield, Wisconsin
- Integrated Resources for the Middlesex Area, LLC, Middletown, Connecticut
- Forsyth Medical Group, Winston-Salem, North Carolina
- St. John’s Health System, Springfield, Missouri
- University of Michigan Faculty Group Practice, Ann Arbor, Michigan