Medicare study: Geisinger demonstrates outstanding diabetes care Geisinger is one of ten group practices nationwide engaged to redesign care to improve results

DANVILLE, PA. –The Centers for Medicare & Medicaid Services (CMS) announced today that Geisinger Clinic, and the nine other physician groups participating in the CMS-sponsored Physician Group Practice (PGP) Demonstration, significantly improved the quality of care for patients with diabetes during the first performance year of the Demonstration.  Collectively, for their 223,893 Medicare beneficiaries with diabetes, the physician groups achieved all 10 nationally developed performance standards chosen for this Demonstration.  Specifically, Geisinger-managed Medicare beneficiaries with diabetes experienced significant improvements in lab testing, cholesterol control and vaccinations. 

Geisinger, like the other participating physician groups, redesigned care to improve clinical quality and to reduce costs through more efficient and effective care delivery. During the first year of this multi-year Demonstration, the physician groups’ yielded $21 million in savings for Medicare under the demonstration’s methodology.  “Creating incentives that reward physicians for providing evidence-based care works and is the right thing to do,” said Dr. Albert Bothe Jr., Geisinger’s Associate Chief Medical Officer and Chief Quality Officer.

An estimated 16 million Americans have diabetes and often suffer from hypertension, kidney failure and are particularly susceptible to common infections. Diabetes is the sixth leading cause of death in the United States. 

“Diabetes is linked to so many other problems that it’s really hard to manage,” said Dr. Steven B. Pierdon, Geisinger’s Chief Medical Officer, Clinical Enterprise and Community Practice.  “Hospitals and providers need to consider an integrated care approach, one that involves primary care doctors, clinical specialists, nurse case managers and advanced information technology.”

Kicked off in January 2006, Geisinger’s ProvenCare^SM Diabetes program utilizes its advanced Electronic Health Record (EHR) to provide regular feedback to physicians and patients with high-risk chronic conditions. The EHR automatically reminds patients to schedule appointments for services, such as vaccinations, and assists health care workers in identifying “gaps in care”. Early success with the program shows the number of diabetic patients receiving pneumococcal vaccinations went increased from 59 percent to 83 percent (March 2006 to March 2007).  During that time, the number of diabetic patients receiving flu vaccines increased from 57 percent to 73 percent. 
 

“The best way to provide more thorough care and manage diabetes is to give the patient’s primary physician access to a broad range of resources, especially the EHR; another tactic is to involve patients in their care.”  Bothe said.  “Our physicians saw significant change by instituting a number of small changes such as making patients’ lab results available to their physicians prior to a patient encounter, preparing patients for foot exams and educating patients about the importance of self-care in diabetes and following-up with them in between visits.  Involving patients in their overall health ultimately improves their health and reduces costs.” 

In addition, Geisinger and the other nine physician groups developed new systems to prevent avoidable hospitalizations.  These new care management initiatives included high-risk case management, home-based monitoring, post-discharge transition care management, and palliative care services. 

“We are anxiously awaiting the results of these additional interventions when Performance Year 2 data becomes available” said Dr. Mark Selna, Geisinger’s Associate Chief Innovation Officer.

One of the unique features of this Demonstration is that there are no reductions in benefits to any beneficiary; rather, beneficiaries receiving care associated with this Demonstration are receiving additional services to help them maintain their health and avoid further illness and admissions to the hospital.  In the subsequent years of this Demonstration, the clinical quality improvement efforts will expand to include coronary artery disease, congestive heart failure, hypertension and cancer screening.

Geisinger Clinic is one of ten participants in the PGP Demonstration Project, and the only one in Pennsylvania. Geisinger Clinic is the physician group practice within the Geisinger Health System. There are more than 600 physicians within Geisinger Clinic.

Part of a fully integrated healthcare system, Geisinger Clinic was chosen for several reasons including demonstrated success in chronic care management, diabetes quality, and its advanced electronic health record. 

The Medicare Demonstration Project will last until March 31, 2008, but may be extended. 

For more information on Medicare Payment Demonstrations sponsored by the Centers for Medicare & Medicaid Services, go to www.cms.hhs.gov/DemoProjectsEvalRpts.