Better treatment and care that costs less results in savings for Medicare, demonstrates benefits of Accountable Care Organizations
U-M achieved both of the project's aims: to provide the highest-quality care and reduce health care spending growth for all traditional Medicare patients, including those with costly chronic illnesses.
This is the fourth year in a row that U-M has achieved both sizable savings and high scores on health care quality benchmarks as part of the project. One more year of data remains to be collected and analyzed.
The U-M Faculty Group Practice, part of the U-M Medical School, includes all of the nearly 1,600 U-M faculty physicians who care for patients at the three U-M hospitals and 40 U-M health centers.
"The U-M Faculty Group Practice invested significant time and resources in this project because it provided the opportunity to develop and test potential interventions that could improve clinical outcomes and reduce costs for patients with chronic disease," says David Spahlinger, M.D.,senior associate dean for clinical affairs. "Our investments have enabled better coordination of care and demonstrated to the nation that ACOs are worth pursuing."
The report is based on data from over 18,000 Medicare participants who received most of their care at U-M during the 12-month period that began April 1, 2008.
The project does not include those who were enrolled in a Medicare Advantage plan offered by a private health plan, nor Medicare participants who received only limited care at U-M. But the improvements made for the project are helping other patients as well.
The project began by focusing on the quality of care of patients with diabetes, but was expanded in its second year to include congestive heart failure and coronary artery disease - both chronic heart conditions that carry a very high risk of emergency hospitalization and other higher-cost care if not managed appropriately. In the third year, the program was further expanded to include hypertension - another high-risk and costly condition - and breast and colorectal cancer screenings.
During the years it has participated in the project, U-M has launched a number of new programs to help improve care for all patients seen at U-M. U-M has implemented transitional care programs designed to assist patients with hospital discharge information and follow-up activity. Also started were complex care coordination programs designed to reduce unnecessary treatments, readmissions, handoffs and wait times, as well as a medical home program where a patient and his/her personal physician partner to identify, provide, and coordinate all needed services across multiple locations and settings.
U-M's Faculty Group Practice is the only organization in Michigan taking part in the project. It was chosen for several reasons, including demonstrated success in chronic care management, diabetes quality and organizational structure.
The other physician groups participating in the project are Billings Clinic, Billings, MT; Dartmouth-Hitchcock Clinic, Bedford, NH; The Everett Clinic, Everett, WA; Forsyth Medical Group, Winston-Salem, NC; Geisinger Clinic, Danville, PA; Marshfield Clinic, Marshfield, WI; Middlesex Health System, Middletown, CT; Park Nicollet Health Services, St. Louis Park, MN; and St. John's Health System, Springfield, MO.