Information Technology Reference
In-Depth Information
Fig. 2.2 More Physicians Caring for a Patient Can Lead to More Errors
2 years; or who were hospitalized; or had major surgery in past 2 years. The study
showed that, among other results, specialists see patients without having their medi-
cal records around 20% of the time and that 30% of patients are discharged from
hospitals without specific medication instructions. In sum, as shown in Fig. 2.2 ,
43% of these patients reported a medical mistake, medication error, and/or lab test
error or delay when they were seen by four or more physicians versus 25% by those
who were seen by 1 or 2 physicians.
The details are again beyond the scope of this topic and, in part, are not yet clear,
but an ACO offers to share savings with a self-organized provider group so long as it
also produces quality measures at or above some pre-defined level. In practice the
group might be a hospital and physician practices it owns or collaborates with. It might
be medical practices, home health and long term care providers and pharmacists who
band together using health information technology to deliver more coordinated care.
Much of the belief that this approach can work comes from a pilot program in ten
large physician group practices (PGPs) begun in 2005 and funded by the Centers for
Medicare & Medicaid Services (CMS), the huge federal agency that manages both
the Medicare program to provide healthcare for the elderly and the Medicaid pro-
gram for the poor and people with certain disabilities. The purpose was “to examine
whether care management initiatives could generate cost savings by reducing avoid-
able hospital admissions, readmissions, and emergency department visits, while
improving quality results”. [ 16 ] All PGPs met at least 29 of the 32 quality goals,
most of which were process measures related to coronary artery disease, diabetes,
heart failure, hypertension, and preventive care. Five generated Medicare savings of
$38.7 million, earning performance payments of $31.7 million. Marshfield Clinic,
Search WWH ::




Custom Search