Medicare Quality Incentives Could Transform U.S. Health Care System, Opinion Piece States

Main Category: Medicare / Medicaid / SCHIP
Article Date: 06 Sep 2007 - 20:00 PST

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The Physician Quality Reporting Initiative, under which Medicare will begin to pay physicians a 1.5% bonus incentive for reporting quality measures, "represents a significant step toward public reporting and pay for performance," infectious disease physician Manoj Jain, a medical director for Medicare's quality improvement organizations in Tennessee and Georgia, writes in a New York Times opinion piece. According to Jain, "Soon doctors will be paid according to quality and value," and performance will be publicly reported to allow patients to "choose the best doctors." Jain adds, "With doctors' reputations at stake, they will have an incentive to improve."

Jain continues, "Just as managed care swept the health system a decade ago and left its mark, so should this new policy," called value-based purchasing. However, "such an approach has several potential land mines. Doctors will have an incentive to treat the less ill patients, because the outcome is bound to be better," Jain writes. In addition, physicians "already fed up with the bureaucracy and paperwork of Medicare may wash their hands of the program and refuse to see any Medicare patients, just as vast numbers of baby boomers begin turning 65 and entering the program," according to Jain. Jain concludes, "How value-based purchasing will affect health care only time and human behavior will tell. But change is urgent for our misaligned health care system" (Jain, New York Times, 9/4).

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