In a nationwide program that aimed to provide better care at a lower cost for Medicare participants, the University of Michigan made the most progress in reducing costs and improved the quality of care patients received.
The gains were largest among patients who rely on both Medicare and Medicaid for their health coverage - a high-cost group that needs more coordinated care.
Those findings come from a new independent analysis published this week in the Journal of the American Medical Association by researchers from the Dartmouth Institute for Health Policy and Clinical Practice.
The researchers say their findings show the power of new health care delivery models that reward providers for coordinating and improving care - especially for the sickest, costliest patients in the health care system.
That formula for rewarding coordination, quality and cost containment forms the foundation for Accountable Care Organizations, or ACOs, that are now springing up around the country, spurred on by federal health care reform.
In the new analysis, the Dartmouth researchers looked at results from the five-year Physician Group Practice demonstration project, which took place from 2005 to 2010 and involved 10 large physician groups across the country.
The U-M Faculty Group Practice, composed of the physicians who are faculty within the University of Michigan Medical School, was one of the 10 groups that participated in this program.
An earlier analysis of the five-year project showed that U-M's coordinated care and attention to quality measures led to at least $22 million in savings to Medicare, and gave patients better care as measured by a number of specific targets, such as blood pressure control. Because of this performance, U-M shared in the savings with Medicare. In 2011, the U-M Health System formed a Pioneer ACO to continue this effort on an even broader scale.
Now, the new study finds that U-M was able to decrease annual spending by $2,499 for each patient who had both Medicare and Medicaid coverage. These "dual eligible" patients, as they are called, tend to have medical costs that are higher than people who use Medicare alone - as a group, they account for 31 percent of all Medicare spending and 39 percent of all Medicaid spending.