This article is more than 5 years old. Information may no longer be current.
Congress avoids pay-for-performance mandates
In addition to averting physician Medicare payment cuts, Congress’ new deficit bill also saves physicians from immediate pay-for-performance directives.
Proponents of such initiatives say that binding physician payments with quality measures will improve patient care and decrease Medicare expenditures. Yet physician groups maintain that mandating these programs with the current physician payment formula would be asking physicians to do more work for less money.
“I’m glad that they [Congress] did not impose pay-for-performance measures because it’s difficult without fixing the flawed formula,” Stuart L. Weinstein, MD, president of the American Academy of Orthopaedic Surgeons (AAOS), told Orthopedics Today.
Although the bill does not enforce physician pay-for-performance plans, it does not hinder the collection of quality-related data.
“I think that the readers need to know that CMS [the Centers for Medicare & Medicaid Services] will begin asking for reporting data now,” Weinstein said. “That’s going to happen no matter what.”
Pilot programs better care
CMS has started several quality-related pilot programs, including demonstrations to better senior care and outcomes for chronically ill patients. Medicare issued more than $8 million to centers that improved patient care in the Premier Hospital Quality Incentive demonstration, according to a CMS press release.
Should government officials legislate these programs in the future, medical groups hope to propose realistic measures that truly correlate with better patient outcomes, Weinstein said.
“The other thing is that, while all physician groups, including the AAOS, are very much interested in improving quality, when [legislators] do mandate pay for performance, it’s really important that the performance measures are developed by the physicians, that they are pilot-tested [and] that they are risk adjusted ... so that they are meaningful parameters,” he added.
For more information:
- The Centers for Medicare and Medicaid Services Web site: cms.hhs.gov.