Better care, lower costs: Michigan Medicine leading the way

U-M has been at the national forefront of one of the most important trends in medicine today: population health.

This quest for better care quality, better health for entire populations, and lower health care costs will only increase in importance in coming years.

We got in on this trend on the ground floor, by participating in a Medicare demonstration project that began in 2005 and became the prototype for the Accountable Care Organization (ACO) movement. We have also played leadership roles in efforts funded by private insurers and state agencies.

We have formed two ACOs, and helped launch a statewide patient-centered medical home effort. Below, you'll find more about each of these efforts and more.

In a Jan. 2, 2013 letter to JAMA, two Dartmouth researchers wrote, "If all institutions behaved like the University of Michigan under the system of ACOs, the potential savings would be enormous."

For the media: To arrange interviews with Dr. David Spahlinger or Dr. Tim Peterson, Dr. Brent Williams and other leaders involved in Michigan Medicine population health initiatives, please call Kara Gavin at 734 764 2220 or email kegavin@umich.edu.

 

Learn more:

 

The forerunner of ACOs:
Medicare Physician Group Practice (PGP) Demonstration Project
(2005-2011)

Summary of JAMA paper: independent analysis of project results (Sept. 2012, Dartmouth)

JAMA paper - 2012;308(10):1015-1023. doi:10.1001/2012.jama.10812

Summary of final results (Aug. 2011)

Fast facts: Involved all 1,700+ members of the U-M Faculty Group Practice and thousands of Medicare fee-for-service patients. U-M was one of 10 PGPs to take part nationally, and one of only 2 that both met quality goals and reduced costs. More than $22M in Medicare spending saved, highest savings seen in dual-eligible (Medicare/Medicaid) patients.

 

Pioneer ACO: U-M Faculty Group Practice and IHA - launched Jan. 1, 2012

Announcement (Dec. 2011)

Expansion to include Packard Health and Saline internist (April 2013)

First-year results & announcement of intent to transition from Pioneer to MSSP ACO model (July 2013)

Website

Fast facts: One of 32 nationwide, involved the collaboration of more than 1,700 U-M, 310 IHA and 5 HVPA physicians caring for more than 23,000 Medicare fee-for-service patients. The Pioneer ACO ended at the end of 2013 and its members transitioned to POM ACO in 2014.

 

Physician Organization of Michigan ACO (POM ACO):

A Medicare Shared Savings Program ACO - launched Jan. 1, 2013, expanded 2014

2016 results announcement - October, 2017

2015 results announcement - August, 2016

2014 results announcement - August, 2015

2013 results announcement - September, 2014

Expansion announcement - to include Pioneer ACO members - March 2014

Original CMS press release

Original POM-ACO press release

Website

Fact sheet

Questions & Answers

Fast facts: Involves more than 6,000 physicians and other providers from physician groups across Michigan, and over 95,000 Medicare fee-for-service patients

Physician groups with members in POM ACO

 

Patient-centered medical home initiative: MiPCT

Announcement

Website

Transition to State Innovation Model for Patient Centered Medical Home

Fast facts: Three-year multi-payer project involving 500+ primary care practices & 1,800 primary care physicians affiliated with 41 physician/physician hospital organizations (POs/PHOs). UMHS is the project manager and the Michigan Department of Community Health is the lead oversight agency. Ended December 2016, with a transition to a State Innovation Model funded by a federal grant to the state of Michigan.

 

 

Organizations within UMHS involved in population health:

The Faculty Group Practice, part of the Medical School, serves as the physician organization for all 2,000+ U-M faculty physicians, who care for patients at the U-M Hospitals & Health Centers, the VA Ann Arbor Healthcare System, and select partner locations. Founded in 1996, the FGP manages the UMHS ambulatory care network of health centers in Ann Arbor and surrounding communities. It has a longtime commitment to efforts to improve quality of care, and reports a number of its own clinical quality and patient rating measures publicly via the UMHS Quality & Safety site.

The Population Health Office was created in January 2012 to manage the various population-based patient care delivery, quality improvement and reimbursement pilot programs in which the UMHS Faculty Group Practice (FGP) participates.  The office collaborates with the FGP Quality Management Program, and Ambulatory Care Services, as well as local and regional providers to develop and provide innovative ways to better deliver high quality, efficient care to specific UMHS patient populations.

The Complex Care Management Program was formed in 2005 to coordinate care for UMHS patients with the highest level of need, including physical illnesses, mental illness, homelessness, and lack of adequate health insurance.  To date, the program has seen drastic reductions in hospital admissions, ER visits, and total costs for this specific population of patients. 

The Michigan Care Management Resource Center assists and supports Michigan primary care and specialty practices as they build upon their current Patient Centered Medical Home (PCMH) and PCMH – Neighbor (PCMH-N) capabilities.

 

Publications and news stories about our efforts:

Al Jazeera America TV - feature story on Complex Care Management Program and Pioneer ACO, November 2013:
Part 1    Part 2

The Association of American Medical Colleges has showcased our efforts in a case study of care management.

Case management keeps high utilizers out of hospital  - Insurancenewsnet, July 2012

Caring for the Costliest - Hospitals & Health Networks magazine cover story, Nov. 2012