Table 1.
Spending Changes Associated With the Physician Group Practice Demonstration Overall and by Sitea
| Beneficiary Type | Participant 2001–2004 Spending Annually per Beneficiary, Mean (95% CI) US $b | Estimated Change in Spending Associated With PGPD Annually per Beneficiary, Estimate (95% CI), US $
|
|
|---|---|---|---|
| Adjusted by Low Variation Condition (LVC) Ratec | Adjusted by Hierarchical Clinical Category (HCC) Scored | ||
| All PGPD participants | |||
| All | 7915 (7830 to 7999) | −114 (−216 to −12) | −496 (−524 to −468) |
|
| |||
| Dually eligible | 10 495 (10 211 to 10 780) | −532 (−786 to −277) | −751 (−790 to −712) |
|
| |||
| Nondually eligible | 7549 (7461 to 7636) | −59 (−166 to 47) | −404 (−428 to −380) |
|
| |||
| Billings Clinic | |||
| All | 7196 (6890 to 7501) | −309 (−373 to −245) | −103 (−116 to −90) |
|
| |||
| Dually eligible | 9350 (8199 to 10 501) | −331 (−623 to −39) | −271 (−335 to −207) |
|
| |||
| Nondually eligible | 6950 (6637 to 7264) | −278 (−319 to −236) | −24 (−37 to −11) |
|
| |||
| Dartmouth-Hitchcock Clinic | |||
| All | 8418 (8173 to 8662) | 132 (39 to 226) | −665 (−705 to −625) |
|
| |||
| Dually Eligible | 12 040 (11 067 to 13 013) | −397 (−826 to 32) | −1310 (−1349 to −1271) |
|
| |||
| Nondually eligible | 8018 (7769 to 8266) | 111 (17 to 206) | −492 (−528 to −456) |
|
| |||
| Everett Clinic | |||
| All | 7667 (7239 to 8094) | 116 (−26 to 259) | 466 (445 to 486) |
|
| |||
| Dually eligible | 10 639 (9412 to 11 866) | 287 (111 to 462) | 407 ( 376 to 438) |
|
| |||
| Nondually eligible | 7066 (6618 to 7514) | 125 (2 to 248) | 177 (164 to 189) |
|
| |||
| Forsyth Medical Group | |||
| All | 7300 (7017 to 7582) | −276 (−457 to −95) | −571 (−586 to −557) |
|
| |||
| Dually eligible | 10 803 (10 002 to 11 604) | −742 (−955 to −528) | −522 (−552 to −492) |
|
| |||
| Nondually eligible | 6532 (6238 to 6826) | −194 (−403 to 16) | −185 (−196 to −173) |
|
| |||
| Geisinger Clinic | |||
| All | 7294 (7067 to 7522) | 252 (166 to 337) | −745 (−787 to −704) |
|
| |||
| Dually eligible | 8843 (8150 to 9536) | 79 (−165 to 323) | −376 (−422 to −330) |
|
| |||
| Nondually eligible | 7020 (6782 to 7258) | 297 (216 to 378) | −471 (−498 to −443) |
|
| |||
| Marshfield Clinic | |||
| All | 7284 (7113 to 7455) | −642 (−725 to −559) | −1119 (−1151 to −1087) |
|
| |||
| Dually eligible | 8739 (8161 to 9317) | −987 (−1209 to −765) | −1797 (−1839 to −1756) |
|
| |||
| Nondually eligible | 7095 (6917 to 7272) | −520 (−636 to −405) | −1266 (−1300 to −1231) |
|
| |||
| Middlesex Health System | |||
| All | 8785 (8477 to 9093) | 749 (698 to 799) | 93 ( 66 to 121) |
|
| |||
| Dually eligible | 12 447 (11 315 to 13 579) | 598 (194 to 1002) | 462 ( 416 to 508) |
|
| |||
| Nondually eligible | 8343 (8027 to 8659) | 701 (635 to 768) | 169 (143 to 195) |
|
| |||
| Park Nicollet Clinic | |||
| All | 7070 (6796 to 7344) | −16 (−98 to 65) | −65 (−76 to −55) |
|
| |||
| Dually eligible | 10 051 (8932 to 11 170) | −1610 (−1708 to −1512) | −1058 (−1105 to −1010) |
|
| |||
| Nondually eligible | 6737 (6460 to 7014) | 188 (114 to 262) | −49 (−63 to −35) |
|
| |||
| St John’s Clinic | |||
| All | 7152 (6954 to 7350) | −70 (−205 to 64) | −29 (−38 to −20) |
|
| |||
| Dually eligible | 9426 (8787 to 10 064) | 78 (−40 to 197) | 254 (245 to 264) |
|
| |||
| Nondually eligible | 6810 (6604 to 7016) | −102 (−226 to 21) | −133 (−143 to −124) |
|
| |||
| University of Michigan Faculty Group Practice | |||
| All | 12 714 (12 234 to 13 193) | −866 (−918 to −815) | −1155 (−1174 to −1137) |
|
| |||
| Dually eligible | 17 511 (15 923 to 19 100) | −2499 (−2627 to −2371) | −2072 (−2098 to −2045) |
|
| |||
| Nondually eligible | 12 043 (11 545 to 12 542) | −717 (−776 to −657) | −620 (−635 to −606) |
Abbreviation: PGPD, Physician Group Practice Demonstration.
This table is based on author analyses of Medicare claims files, 2001–2005 (20% sample), 2006–2009 (100% sample).
Spending capped at $100 000 annually per beneficiary and inflated to 2009 US dollars using the gross domestic product deflator.
A negative number in this column represents savings. Estimates derived from a linear model adjusting for area-year indicators, age, black race, woman, Medicaid eligibility, and disability. The model adjusts for zip code–level rates of poverty and high income. The model adjusts for the rate of low-variation conditions for each of the 10 local areas for each year separately for treatment and control groups. Low-variation condition rate is the number of individuals experiencing the conditions hip fracture, stroke, colon cancer, and acute myocardial infarction per thousand Medicare beneficiaries.
A negative number in this column represents savings. Estimates derived from a linear model adjusting for area-year indicators, age, black race, woman, Medicaid eligibility, and disability. The model adjusts for zip code–level rates of poverty and high income. The model adjusts for the individual beneficiary’s hierarchical condition categories.