The Medicare Physician Group Practice Demonstration

Designing and implementing a model to improve health care and control costs through Accountable Care Organizations

By Gregory Pope

Successful Accountable Care Organizations (ACOs) put patients at the center of the health care system by making sure they get the care they need while avoiding unnecessary and wasteful services. Patients benefit from receiving higher-quality and coordinated care while maintaining the freedom to choose their medical care providers, and providers benefit by sharing in the cost savings that are generated by the ACO.

For more than 20 years, RTI has worked with the Medicare program to develop and refine the present-day ACO model. Our work began with Physician Group Practice (PGP) demonstrations—a precursor to ACOs—which our economists and health policy experts helped develop and evaluate. Our 2014 assessment found that these early PGP demonstrations resulted in Medicare cost savings and improved the quality of care for beneficiaries. These demonstrations also served as a test bed for RTI to help the Centers for Medicare & Medicaid Services (CMS) refine the current ACO concept.

It is a complex endeavor to make ACOs simultaneously work for the Medicare program, health care providers, and patients. RTI’s project team incorporates a diverse array of disciplines and perspectives into our approach including experts in health policy, economics, medical care, quality measurement, and risk adjustment.