Wednesday, January 4, 2012

Cruel Tutelage From the Group Practice Demonstration for ACO Wannabes

Data is in there somewhere!
Remember the Physician Group Practice Demonstration?  Its results were used by CMS to justify Accountable Care Organizations (ACOs) with the luster of millions of dollars in shared savings and the thrill of being a "partner" with the world's largest health insurance behemoth, intent on "achiev[ing] a transformed and modernized health care system."

The Disease Management Care Blog has never been all that impressed by CMS' bluster.  It became less so when it checked out this short video by a physician leader from one of the Group Practice Demo participating organizations.

It's an interesting story. After being confronted by suboptimal quality scores in the first year of the Demo, the provider organization naturally responded with corrective programs.  However, there was also an 18 month delay in CMS' ongoing provision of the quality measures.  Since too much money was riding on meeting the CMS' performance threshold, they had to develop their own internal reporting systems. Without them, they would have been flying blind and unable to gauge whether they were making any progress.
Another lesion from the Group Practice Demo?  If you're going to be an ACO, don't count on the Feds and mistake CMS' size or promises for nimbleness or action.  And make sure you have your own data resources and dashboards to manage the quality "real time."

Image from the Lawrence Livermore National Laboratory

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