�Older patients
with heart disease and diabetes are getting better treatment than ever at
the University of Michigan Health System -- even while U-M's care for
Medicare patients is costing less, a new composition shows. The data come from
the second year of a national project undertaken by 10 big physician
groups, including the U-M Faculty Group Practice.
The results were proclaimed in Washington, D.C., by the Centers
for Medicare and Medicaid Services. CMS oversees the Medicare system and
launched the send off to encourage innovation, efficiency and the
development of quality melioration efforts that might be used by doctors
and hospitals countrywide.
U-M was one of only deuce participating groups that achieved both of the
project's aims: to provide the highest-quality care on all 27 of the
project's heart and diabetes measures, and to contain wellness care outlay
growth for all traditional Medicare patients, including those with costly
chronic illnesses.
As a result, U-M will acquire to keep $1.24 million of the support that
Medicare would have otherwise played out on the care of U-M patients in that
year, and will besides earn more than $460,000 as an incentive for providing
high-quality fear.
This is the second year in a row that U-M has achieved both sizeable
savings and high oodles on health care character benchmarks as part of the
project, even as the project was expanded to admit patients with heart
unsuccessful person and coronary thrombosis artery disease. Two more years worth of data remain to
be self-contained and analyzed.
The U-M Faculty Group Practice, percentage of the U-M Medical School,
includes all 1,500 U-M faculty physicians who concern for patients at the
three U-M hospitals and 40 U-M health centers. Many of the programs and
innovations that U-M has set in shoes for this project involve not only when
physicians but nurses, social workers, concern managers and others world Health Organization are
involved in the care of Medicare patients at all U-M facilities.
The report is based on information from about 20,000 Medicare
participants who standard nearly all their tutelage at U-M during the year that
began April 1, 2006. It does not admit those world Health Organization were enrolled in a
Medicare Advantage plan offered by a private wellness plan, nor Medicare
participants who received only limited care at U-M. But the improvements
made for the project are serving many other patients.
"The U-M Faculty Group Practice funded this project because we thought
it was the correct way to care for our patients," says David Spahlinger,
M.D., senior associate dean for clinical personal matters. "We felt confident we
could meliorate quality simply we were uncertain if our interventions would save
money. I believe that this project will provide many lessons for policy
makers as the land confronts the rising costs of health care."
The project's formal name is the Medicare Physician Group Practice
Demonstration. It is Medicare's first-class honours degree Pay for Performance Demonstration
Project to work directly with doctor groups. It began by focusing on the
quality of maintenance of patients with diabetes, but in the second year was
expanded to include gist failure and coronary artery disease - both
chronic heart conditions that carry a very high risk of exposure of emergency
hospitalization, and other concern, if not managed suitably.
Because of its involvement in this project, U-M is as well automatically
active in some other Medicare project, the Physician Quality Reporting
Initiative or PQRI. In fact, the $460,000 that U-M earned for achieving
superiority care on 27 benchmarks is existence paid through PQRI. The dollars
U-M earned for saving Medicare money are calculated using a sort out
formula.
U-M's success in both years of the project bathroom be largely attributed to
efforts to redesign the way patients are cared for, to enhance coordination
and efficiency and cut the demand for emergency care and repeat infirmary
stays.
Project leader Caroline Blaum, M.D. - associate professor of internal
medicinal drug, associate top dog of geriatric medicine and a enquiry scientist at
the VA Ann Arbor Healthcare System - notes that many faculty and staff from
the Faculty Group Practice and Hospitals & Health Centers worked together
to make the changes possible. Both entities are under the bigger umbrella
of the U-M Health System, which makes collaboration easier.
"The advanced thinking and willingness to do what's right for
patients regardless of the prospect of direct reimbursement has truly been
exceptional," she says. "And in the end, we cause been able-bodied to show that
innovations can pay off in both improved care for patients and savings for
Medicare."
In the showtime year of the project, U-M implemented a phone number of new
tactics to help improve care for Medicare patients, most of which are still
in place today. In the second year, that effort was expanded and a number
of new programs made their debut. Among them:
Sub-acute Care Service: This program brings U-M physicians and nurse
practitioners specializing in geriatric upkeep directly into certain nursing
homes in the Ann Arbor, Ypsilanti, Canton and Plymouth, Mich., areas. The
clinicians help patients laid-off from U-M hospitals to these nursing
homes, and their work has already decreased the number of days patients
spend in the hospital.
CHOICES (Creating Healthcare Options to Inpatient Care and Emergency
Services): This sweat provides a nurse practitioner and social worker world Health Organization
can travel to a patient's rest home soon after he or she goes home from the
hospital, to aid with issues such as diabetes management. This program is
available to a large number of U-M patients wHO need specialized in-home
guardianship soon later on being discharged from the hospital, to help them until they
can see their regular doctor.
Expanded Inpatient Geriatrics Consult Service: This service makes it
easier for U-M geriatricians, who specify in the care of older adults,
to assist other U-M physicians in assessing and managing the needs of older
hospitalized patients - no matter what their main rationality for being in the
hospital.
Emergency Medicine Consult/Referral Service: Designed for any patient
seen at the U-M Emergency Department wHO needs followup care of any tolerant,
this programme helps see that they get appointments at U-M clinics. The
program's staff members make telephone touch with patients soon after
they return home, and coordinate their scheduling while also alertness their
primary care doc and processing insurance authorizations.
U-M's Faculty Group Practice is the only formation in Michigan
taking share in the project. It was chosen for several reasons, including
demonstrated success in continuing care management, diabetes caliber and
organizational structure. For more information on the project, inspect
http://www.cms.hhs.gov/DemoProjectsEvalRpt. Click on "Medicare Demonstrations"
and then lookup for "Medicare Physician Group Practice Demonstration."
University of Michigan Health System
http://www.med.umich.edu
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