Marshfield Clinic, a nonprofit multispecialty group practice in central Wisconsin, joined Medicare's Shared Savings Program in 2013, following its success in Medicare's Physician Group Practice demonstration--the program's forerunner. The clinic's Medicare ACO benefits from the organization's past investment in advanced primary care infrastructure and disease-specific care management capabilities, which have yielded reductions in hospitalization and readmission rates. The clinic has an advanced, internally developed electronic health record system and enterprise data warehouse, which allow internal performance reporting and identification of best practices that have galvanized physician support for quality improvement efforts. Marshfield Clinic's track record of achieving cost savings and quality targets set by Medicare suggests the importance of combining mission-driven performance improvement initiatives with a commitment to mutual accountability among providers in group practice.
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