Continuing the Shift to Consumer-driven Healthcare... CMS to Provide Physician Quality Measures to Medicare Beneficiaries

(PYA Alert dated March 15, 2007)

In February 2007, Centers for Medicare and Medicaid Services (CMS) announced an initiative that will provide performance information to beneficiaries. Through its partnership with Delmarva Foundation Medical Care and four regional collaboratives in Indiana, Massachusetts, Minnesota, and Wisconsin, physician quality measures will soon be provided to Medicare beneficiaries. This new program was established as a part of the Better Quality Information to Improve Care for Medicare Beneficiaries (BQI) project. The objective for the new initiative, which supports the goal for BQI, is twofold: to provide physicians with performance data that will assist them in improving the quality of healthcare delivered to Medicare beneficiaries, and to provide Medicare beneficiaries with physician performance data to assist them in choosing a provider.

Quality initiatives have risen exponentially within healthcare organizations over the last few years. In January 2006, CMS started a Physician Voluntary Reporting Program (PVRP) that provides financial incentives for physicians to report quality metrics and outcomes. The PVRP program was quickly discontinued and replaced with the Physician Quality Reporting Initiative (PQRI) which ties an incentive payment for physician reporting of quality initiatives in the second half of 2007.

Other than reputation and general discourse, consumers of healthcare typically do not know the quality of their physician. Reporting of quality and performance information to Medicare beneficiaries will make physicians transparent and allow consumers to “shop” for healthcare providers. It is also another step toward mandatory reporting of physician performance data. Is your healthcare entity and medical staff prepared for this requirement? How will this affect your organization?

Should you have any questions about this or any other issue pertaining to healthcare quality reporting, please do not hesitate to call PYA. You may contact Marty Brown at (800) 270-9629.

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