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Medicare may target inefficient doctors

Quality Improvement Monitor, May 18, 2007

Medicare has the data and computer capacity to identify doctors who are less efficient than their peers and may begin contacting them as soon as mid-2008 to goad them to become more efficient, a top federal official testified last week, according to the Commonwealth fund's Washington Health Policy Week in Review.

"It's an ambitious goal, but I think we need to set ambitious goals if we're moving forward in this important reform area," said Herbert Kuhn, acting deputy administrator for CMS, the Commonwealth Fund reported.

Kuhn testified at a hearing called by House Ways and Means Health Subcommittee Chairman Pete Stark, (D-CA), to control the growth in the volume of office visits, tests, and procedures that doctors order for Medicare beneficiaries. There's widespread agreement that the current method for doing that -- cutting payments if volume exceeds a yearly spending target -- isn't working, the Commonwealth Fund said.

The evaluations would look at how many tests and procedures a doctor orders for a particular type of patient and compare it with his or her peers who got the same treatment outcome.

Stark said he would like to move quickly on getting information out to doctors about how their efficiency compares with that of other groups or other individual doctors.

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