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CMS, AMA urge pay-for-performance

Physician Practice Advisor, October 5, 2005

The administrator of the Centers for Medicare & Medicaid Services (CMS) and an American Medical Association (AMA) trustee urged further progress on the pay-for-performance bill at the September 29 U.S. House Ways and Means Health subcommittee hearing.

The Medicare Value-Based Purchasing for Physicians Act would scrap the current sustainable growth rate formula calculation and set up a tiered payment system based on quality measures of physician performance.

"Currently, hospitals and physicians are paid under separate systems. Under these systems, physicians do not receive credit for avoiding unnecessary hospitalizations by providing better care to their patients. However, in our physician group practice demonstration project, physicians could receive performance based payments derived from savings from preventing chronic disease complications, avoiding hospitalizations, and improving quality of care," Mark B. McClellan, MD, Ph.D., administrator of CMS, testified.

AMA trustee John J. Armstrong, MD, encouraged caution, however. "Decisions on public reporting should be deferred until program elements, such as risk-adjustment, are resolved. This will reduce the potential for inaccurate information that could negatively impact access to care for vulnerable populations. Public reporting only benefits patients when the information is accurate, relevant and user-friendly," he said at the hearing.

Click here for more information about the hearing.

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