Table 2.
Annual per-beneficiary change in payments associated with PGPDa.
| N | Total payments (95% CI) | Acute care payments (95% CI) | Cancer-specific payments (95% CI) | Imaging payments (95% CI) | Procedures payments (95% CI) | Hospice payments (95% CI) | |
|---|---|---|---|---|---|---|---|
| AH PGPD Participants | 988,781 | −$720.89 (−969, −473) | −$736.62 (−936, −538) | $144.76 (79, 210) | −$12.63 (−43, 18) | $23.22 (−12, 58) | −$83.88 (−138,−30) |
| Billings clinic | 17,579 | −612.75 (−718, −507) | −1401.45 (−1482, −1321) | 117.69 (90, 145) | −28.95 (−43, −15) | −234.67 (−260, −209) | −23.75 (−49, 1) |
| Dartmouth-Hitchcock clinic | 84,085 | −384.61 (−539, −230) | −508.14 (−669, −347) | 148.40 (92, 205) | 78.26 (60, 97) | 128.07 (90,166) | 4.50 (−43, 52) |
| Everett clinic | 94,174 | −417.26 (−576, −258) | −216.36 (−338, −95) | 460.98 (408, 514) | −84.98 (−110, −60) | 179.71 (143, 217) | −430.66 (−490, −371) |
| Forsyth medical group | 58,527 | 1111.78 (836, 1388) | 882.69 (626, 1139) | −49.48 (−132, 33) | −4.43 (−43, 34) | 84.46 (10,159) | 77.27 (−10,165) |
| Geisinger clinic | 115,997 | 149.04 (0, 298) | −257.28 (−394, −121) | −69.50 (−113, −26) | 23.07 (5, 41) | −207.11 (−240, −174) | −24.70 (−63, 13) |
| Marshfield clinic | 43,212 | −612.66 (−883, −342) | −487.38 (−703, −271) | 314.78 (245, 385) | −196.55 (−229, −164) | −20.56 (−53,12) | −146.77 (−195, −98) |
| Middlesex health system | 146,635 | −32.15 (−179,115) | 43.01 (−62, 148) | −311.96 (−348, −276) | 50.63 (35, 67) | 170.10 (148, 192) | 13.91 (−18, 46) |
| Park Nicollet clinic | 74,500 | −447.96 (−690, −206) | −345.11 (−532, −158) | 210.36 (149, 272) | −0.37 (−31, 31) | 223.50 (202, 245) | 133.57 (84, 183) |
| St. John's clinic | 46,557 | −1289.91 (−1731, −0.849) | −640.68 (−0.965, −0.316) | 75.84 (−33,185) | −35.04 (−90, 20) | −108.98 (−141, −77) | −241.66 (−326, −157) |
| University of Michigan Faculty group practice | 307,515 | −3526.58 (−3709, −3344) | −3732.14 (−3891, −3573) | 535.31 (501, 570) | 99.18 (82, 116) | 204.42 (174, 235) | −196.17 (−229, −163) |
PGPD=Physician Group Practice Demonstration, CI=Confidence Interval INotes: Spending is inflated to 2009 US dollars using the gross domestic product deflator. Negative estimates represent savings. Estimates derived from a linear model adjusting for area-year indicators, age, black race, woman, Medicaid eligibility, disability, cancer type, and indicator for metastatic cancer. 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, and acute myocardial infarction per thousand Medicare beneficiaries Source: Author analyses of Medicare claims files, 2001-2005 (20% sample), 2006-2009 (100%)