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January 2, 2013

Savings From the Medicare Physician Group Practice Demonstration—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (

JAMA. 2013;309(1):30-31. doi:10.1001/jama.2012.88179

In Reply: Drs Woolhandler and Himmelstein are concerned that our calculations of overall savings arising from the PGPD neglected to include the costs of bonuses paid to several groups. In our original manuscript, we included an analysis of these costs, leading to an insignificant net savings of about $10 per person per year. We removed this calculation during revision because it is an institutional detail specific to a now-closed demonstration project and shed little light on the cost-saving effect of the new potentially 2-sided non–risk-adjusted payment system available in Medicare ACOs.

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