Indiana, North Carolina host Medicare quality demos

Physicians and health systems in the two states will share savings from coordinating care and developing medical homes.

By Chris Silva — Posted Feb. 10, 2010

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The Centers for Medicare & Medicaid Services on Jan. 27 announced two new Medicare demonstrations that provide incentives for physicians and others to improve the quality of care for Medicare beneficiaries while reducing costs.

One of the programs, in Indiana, is in partnership with the Indiana Health Information Exchange, which was formed in 2004 to promote the efficient exchange of medical records among doctors and hospitals. Under the new demonstration, IHIE will use Medicare data to give participating physicians the information necessary to lower costs and boost quality.

The project, which involves a coalition of roughly 800 physicians, also will examine the impact of quality measures reporting and pay-for-performance.

"Under the current health care system, patient data is often inconsistent and housed in different systems, making it less useful to physicians," said CMS Acting Administrator Charlene Frizzera. The IHIE project will work to combine fragmented data and standardize quality reporting and pay, she said.

In North Carolina, a new demonstration will extend the medical-home concept to low-income Medicare beneficiaries through a partnership with the North Carolina Community Care Networks. The organization consists of eight regional health care networks that combine care coordination and health information technology to manage care more effectively.

The networks, consisting of community physicians, hospitals, health departments and others, will provide medical homes for beneficiaries who are eligible for both Medicare and Medicaid. Each network has clinical care coordinators who will work with practices on medical-home plans for their patients.

Both demonstrations are set up to allow the organizations to share in a portion of Medicare savings once care quality and efficiency objectives are met, CMS said.

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