Comments on the PGP Demonstration from former CMS Administrator

Submitted by jonpearce on Sat, 2011-09-24 17:09

An interesting article in the New England Journal of Medicine by former CMS administrator Gail Wilensky describes some of the complications that participating providers encountered in the Physician Group Practice demonstration project.  These included lack of data provided in a timely manner, which impeded the ability of the participants to effectively manage their populations.  The article relates the results of this demonstration project to the structure proposed by CMS for accountable care organizations, and suggests that "{finding} a better balance between protecting the government from undue financial exposure and encouraging newly formed groups to provide care in ways that can both improve quality and reduce costs... may be harder to accomplish than some had thought".  In particular, the lack of timely data from CMS will require ACOs to develop their own internal data sources for clinical and financial management.