The largest independent physician group in Central Ohio will get bonus payments for keeping the frailest patients well and out of the hospital under a new deal with five private Medicare Advantage plans.
Central Ohio Primary Care Physicians Inc. will get a fixed monthly payment for patients in the pilot program, plus a share of the savings from actuarial estimates of that group’s 2014 medical expenses. The plans also have agreed to pay for sending patients directly to a high-acuity wing of a skilled nursing facility without the usual requirement for a three-day hospital stay.
The average hospital stay costs at least $10,000, said Dr. William Wulf, CEO of the 270-doctor group. The practice’s hospitalists – specialists who follow patients through inpatient stays – say about one-fourth of patients admitted could have been cared for in a less-costly setting, but regulations and existing payment incentives encourage the hospitalization.
“What if that hospitalist was in a shared savings program for that $10,000?” Wulf said. “That’s where we need to go, that’s where we’re going with population health.”
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Medicare Advantage plans to pay Central Ohio Primary Care to keep patients out of hospital