Medicare Physician Reimbursement Provision Latest Example Of Effort To Link Provider Payments With Quality Of Care

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Primary Care / General Practice
Article Date: 19 Dec 2006 - 5:00 PDT

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A bill (HR 6111) that would increase Medicare reimbursements to physicians who report data on certain quality-of-care measures is "the latest example of public and private insurers and employers setting pay-for-performance measurements into contracts," the Chicago Tribune reports (Japsen, Chicago Tribune, 12/14). The bill, which was approved last week by the 109th Congress, would maintain the current level of Medicare physician reimbursements for 2007 and provide a 1.5% increase in reimbursements to physicians who agree to report data on certain quality-of-care measures (Kaiser Daily Health Policy Report, 12/14). Under the bill, physicians in July 2007 would report to the government data on 16 "evidence-based" quality measures, such as how often they prescribe certain drugs for cholesterol or high blood pressure. According to the Tribune, physicians "are not expected to submit data on all of their patients," although Medicare officials have not yet determined what percentage would have to be tracked. Critics of the legislation maintain that the bill "did not go as far as it should have," the Tribune reports. For example, some private-sector employers would like health care providers to face financial penalties if they commit errors. Medicare officials maintain that the bill would collect information that would be useful for expanding pay-for-performance systems in the future, including measures that would penalize physicians for providing low-quality care (Chicago Tribune, 12/14).

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