Dartmouth-Hitchcock Earns Performance Payments for Improving Quality of Care

The Centers for Medicare & Medicaid Services have announced that Dartmouth-Hitchcock Clinic, along with nine other physician groups participating in an innovative, Centers for Medicare and Medicaid Services (CMS)-sponsored Physician Group Practice (PGP) Demonstration, were able to make significant quality gains for patients with certain chronic conditions, while generating $17.4 million in savings for the Medicare program.

All ten of the participating physician groups—Billings Clinic, Everett Clinic, Dartmouth-Hitchcock Clinic, Forsyth Medical Group, Geisinger Clinic, Middlesex Health System, Marshfield Clinic, Park Nicollet Health Services, St. John’s Health System, and the University of Michigan Faculty Group Practice — achieved target performance on at least 25 out of 27 quality markers for patients with diabetes, coronary artery disease and congestive heart failure. In addition, all 10 groups have collectively shown a lower expenditure growth for assigned beneficiaries, totaling $ 34.4 million dollars to date for the PGP demonstration, now in its second year.

In addition, four of the physician groups, including Dartmouth-Hitchcock, were eligible for performance payments under the PGP Demonstration’s performance payment methodology, by generating a total of $17.4 million in savings for Medicare. While the PGP Demonstration was national in scope, the collaborative nature between PGP groups and CMS allowed each site to develop locally-based care programs to enhance quality of care for Medicare beneficiaries.

"At Dartmouth-Hitchcock, this initiative fits right into the organization's mission and its vision to achieve the healthiest population possible," said Dr. Barbara Walters, Dartmouth-Hitchcock's Senior Medical Director. "The program has challenged us to find ways to innovate in the way we deliver care to all of our patients by taking a systems approach to improving the efficiency and the quality of our care. Another key to the program’s success was in allowing us the flexibility to develop systems that worked best for us, and not trying to impose a one-size-fits-all methodology."

However, these physician groups have achieved outstanding levels of performance by using some common elements, including developing “champions” at the practice, redesigning clinical care processes and investing in health information technology. The enhancements to their electronic health records and patient registries allow practices to more easily identify gaps in care, alert physicians to these gaps during patient visits, and provide interim feedback on performance.