Criteria for initially selecting providers to operate under GVPS.
Under GVPS, physician organizations would be expected to manage the whole continuum of care for their patients, which presupposes certain types of expertise and attention to overall quality of care.
Many of these criteria can be adapted to GVPS as well since the goals and methods are similar:
Size thresholds would limit participation to providers with more reliable utilization performance measures, and limit the administrative burden associated with GVPS to a manageable number of practices with the greatest payoff for Medicare.
Since the goal is to focus incentives and responsibility on physicians, one or more physician practices must form the core of a qualified organization for GVPS.
If the demonstration under development is successful, the Federal Government may decide to "roll out" GVPS as a national program under Medicare at some point in the future.
Compared with the current national MVPS, mandatory inclusion under GVPS would likely represent a more focused and equitable application of financial rewards and penalties according to observed differential performance.
GVPS potentially creates a win/win/win situation for Government, providers, and beneficiaries, respectively; thereby potentially making FFS more competitive with other Medicare plans.
Integrated provider organizations are looking for limited risk-bearing opportunities, and GVPS could be one such opportunity.
Since a large majority of physician practices are relatively small (in terms of Medicare patient volume and number of physicians), most providers would have to pool their efforts in order to meet important criteria for GVPS relating to size and/or scope of services.