Thursday, August 21, 2008
Working out the kinks of quality reporting
Medicare released its first round of bonus payments to physicians who reported quality care data. But physicians say the actual payouts are relatively small and might not be worth the record-keeping, and report problems learning how well they performed.
The Centers for Medicare and Medicaid Services (CMS) introduced the Physicians Quality Reporting Initiative in July 2007. The program awards a bonus payment of 1.5% of allowed charges for Medicare patients to physicians who submitted quality measure codes. Since then, between 10 and 15 percent of internists reported at least one quality measure code, and slightly more than half earned a bonus. ACP will report more specific outcomes to members in the near future.
Internist William E. Fox, FACP, an internist in Charlottesville, Va., writes that his practice received a bonus payment below the average amount that Medicare had reported. He said that's probably because his practice is four years old, with a smaller patient panel and fewer Medicare patients.
But established internist W. James Stackhouse, MACP, of Goldsboro, N.C., received his bonus payment and questioned if it's worth continuing participating, even using simplified alternative reporting shortcuts that were released this year. He writes, "It took a lot of paperwork and screwed up billing because we had to charge 1 cent per code so that the Medicare carrier's computer would pick up the charges, and then had to manually write off that charge afterward."
His back-of-the-envelope math estimates a physician could reasonably recoup $6,000 in bonus payments, "which represents an extra 99213 visit only about 120 times in year, or about one every other day of office hours." He added that's little motivatation for the extra record-keeping.
Also, physicians who participated in the 2007 PQRI are supposed to be able to find out how they performed on a secure Web site. However, Dr. Fox has been so far unable to access his reports, a complaint voiced by users during a public forum CMS conducted, according to ACP's Regulatory and Insurer Affairs staff. Since doctors who have a bad first experience may not continue, ACP is reporting its members' frustrations back to Medicare.
Dr. Fox asked, "I wonder what results others have had?" ACP is working with the American Medical Association to survey internists about their experiences, as detailed in a report here.
Labels: quality reporting
posted by Ryan DuBosar at
10:00 AM
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Albert Fuchs,
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Albert Fuchs, MD, FACP, graduated from the
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also did his internal medicine training. Certified by the American
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Amanda Xi, ACP Medical
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she which chronicles her journey through medical training from day
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Zackary Berger, MD, ACP Member, is a primary care doctor and
general internist in the Division of General Internal Medicine at
Johns Hopkins. His research interests include doctor-patient
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Controversies in Hospital
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Run by three ACP
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hands).
db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating
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DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about
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Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more
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Everything
Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science,
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FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the
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Discovery at the Pritzker School of Medicine for the University of
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Ryan Madanick, MD, ACP Member, is a gastroenterologist at the
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I'm dok
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an
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informatics, new medical education modalities, pre-code/code
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quality improvement, and quantitative biomedical imaging.
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David L. Katz, MD, MPH, FACP, is an internationally renowned
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Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of
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KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites
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MD
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Michael Kirsch, MD, FACP, addresses the joys and challenges of
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Elaine Schattner, MD, FACP, shares her ideas on education, ethics
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Rob Lamberts, MD, ACP Member, a med-peds and general practice
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Kimberly Manning, MD, FACP, reflects on the personal side of being
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Paul Sufka,
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Peter A. Lipson,
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Peter A. Lipson, MD, ACP Member, is a practicing internist and
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Janice
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Daniel Ginsberg, MD,
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Other blogs of note:
American Journal of
Medicine
Also known as the Green Journal, the American Journal of Medicine
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Clinical
Correlations
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Member, associate program director at New York University Medical
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Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so
he can create an independent, clinician-reviewed space on the
Internet for physicians to report and comment on the medical news
of the day.
PLoS Blog
The Public Library of Science's open access materials include a
blog.
White Coat
Rants
One of the most popular anonymous blogs written by an emergency
room physician.
3 Comments:
Agree with the frustrations- We received an $800 check and with 4 dcs in the group reporting PQRI in 2007 and no way to get the report on why it is so little, we are all greatly disillusioned with the whole system, but what did we expect from CMS???
ACP Internist has learned that CMS intends to provide more detail on how it arrived at bonus payment amounts, because many who qualified were expecting more. We'll report more here when CMS releases details.
This is not rocket science...it costs more in time and effort as well as technology to do something that makes no sense...
I would use my time and my office staff's time more fruitfully...
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