OCTOBER 28, 2005 -- Centers for Medicare and Medicaid Services (CMS) Administrator Mark B. McClellan announced a new voluntary program Friday for physicians to report evidence-based, consensus quality measures.
In the first phase of the program, which begins in January, Medicare will allow physicians to submit data on 36 quality measures, such as beta blockers given when a patient suffering a heart attack enters the hospital or screening elderly patients for falls. The measures were developed with physicians, physician organizations, and other experts involved in reviewing the quality of the nation's health care, including the National Quality Forum and the RAND Corporation.
The information would not be public, McClellan said during a conference call with reporters, nor would physicians' Medicare compensation be increased.
"We don't think the administrative burdens will be large," McClellan said, adding that CMS staff would examine the issue. Medicare physicians are scheduled to receive a 4.4 percent payment cut January 1 unless Congress takes action to stop it.
Physicians may want to participate in the voluntary program, McClellan said, because they would receive information about how their performance stacks up against their peers' and because there is a clear trend toward "pay-for-performance" programs in both the public and private sector.
Promoting health care information technology and linking Medicare providers' payment to quality of service are top health care legislative priorities for many Republicans and Democrats. Many lawmakers view both measures as a way to curb rising government health care expenditures while improving the quality of care provided.
In June, McClellan sent a seven-page letter to two key House chairmen—Ways and Means Chairman Bill Thomas, R-Calif., and Ways and Means Health Subcommittee Chairman Nancy L. Johnson, R-Conn.—detailing his agency's plan to move forward on a "pay for performance" program for Medicare providers.
McClellan indicated Friday there "could well be" a link between reporting data and receiving higher Medicare payments next year, depending on the outcome of congressional action on the issue this year.
The American Physical Therapy Association said Friday it hoped to work with McClellan to expand the voluntary program to include physical therapists and other non-physician groups. "The transition to a payment system that assures high quality, effective health care services is vitally important to the beneficiaries that physical therapists serve under the Medicare program," the group's president, Ben F. Massey, Jr., said in a statement.