The Centers for Medicare & Medicaid Services (CMS) released 2017 quality reporting ratings for all Medicare Shared Savings Program Accountable Care Organizations (ACOs) and we are excited to announce that Physician Quality Partners (PQP) received an overall quality score of 99.30% out of 100% across the four quality domains (Patient/Caregiver Experience, Care Coordination/Patient Safety, Preventive Health, At-Risk Population). As a top performer in quality, PQP attained the highest available Merit-Based Incentive Payment adjustment available to providers.
In 2013, New Hanover Regional Medical Center (NHRMC) formed Physician Quality Partners (PQP), which is comprised of doctors, hospitals, and other health care providers who have united to help beneficiaries receive the right care, at the right time, in the right setting. Then in 2016, PQP began participating in the Medicare Shared Savings Program. CMS regulates Medicare ACOs, providing key quality objectives and establishing financial benchmarks.
PQP’s care teams use established processes and procedures to ensure that Medicare beneficiaries receive high-quality, coordinated care. Offering preventive care, medication management, patient education, care coordination and many other well established practices, care teams are able to improve the overall health of the beneficiaries. As a result, admissions for PQP beneficiaries dropped 17 percent from fourth quarter of 2016 to fourth quarter of 2018, and the Emergency Department use rate dropped 6 percent from 2017 to 2018.
This performance is reflective of PQP’s focus on ensuring that beneficiaries have access to excellent preventive care and screenings. PQP’s quality performance was above the mean performance compared to all Medicare ACOs on the Influenza Vaccine, Pneumonia Vaccination, Screening for Clinical Depression and Follow-Up, and Breast Cancer Screening measures. For example, the mean performance for all ACOs on the Influenza Vaccination measure was 72.52% and PQP’s score was 91.42%. For the Pneumonia Vaccination measure, the mean performance for all ACOs was 72.92% whereas PQP scored 87.54%. PQP scored a 92.72% for the Screening for Clinical Depression and Follow-Up measure compared to the mean performance for all ACOs of 61.98%. Lastly, PQP received a 91.61% score on the Breast Cancer Screening measure compared to the mean performance for all ACOs of 70.05%. Also, PQP scored above the mean for Medicare ACOs in all eight patient satisfaction measures and showed an ability to improve the health of patients with chronic conditions (such as hypertension, diabetes, and cardiovascular disease). These achievements are further evidence of the innovative and collaborative efforts of PQP.
PQP’s quality performance is important for multiple reasons.
First and foremost, the beneficiaries are receiving quality medical care and are engaging in the recommended course of action to achieve their health goals.
“The health of the beneficiary is the primary objective of the ACO,” said Dr. Amy Messier, PQP Medical Director. “The physician practices involved with PQP’s mission have committed to following best practices to help the beneficiaries achieve optimal health, and their dedication proves how much they care about the health of our community.”
Secondly, providers are working more closely together to coordinate care, reduce costs for patients, and improve health outcomes for our region.
“By coordinating care, reducing duplication and helping beneficiaries stay on track with medication and preventative care, PQP providers are helping reduce hospitalizations and Emergency Department visits,” said Lydia Newman, PQP Executive Director. “That reduces the overall cost to both beneficiaries and providers.”
If you have questions or concerns about Physician Quality Partners, call us at (910) 667-7640 or visit our website at https://www.nhrmc.org/pqp. You also can call 1-800-MEDICARE (1-800-633-4227), TTY users should call 1-877-486-2048 and tell the representative you’re calling to learn more about ACOs or visit Medicare.gov/acos.html.