Pay for performance coming to physician offices in 2007

Why This Topic Matters

Physician practices needed to understand an emerging Medicare quality-reporting workflow that could affect claim submission, reporting processes, and future reimbursement incentives.

Article Sections

1. Introduction to physician pay-for-performance

   Introduces CMS’s move toward quality-based physician reporting and its expected role in future Medicare payment policy.

2. Physician Voluntary Reporting Program details

   Summarizes the voluntary reporting program, CMS guidance, and the general reporting framework described in agency materials.

3. Coding and claim submission considerations

   Discusses operational issues practices may face when reporting quality measures on claims and the need to align reporting with supporting diagnosis and procedure information.

4. Electronic health records and future transition

   Covers CMS’s stated direction for moving from interim claims-based reporting toward electronic submission of clinical data.

5. Relationship to CPT Category II and Quality Net Exchange

   Explains the article’s discussion of measure-reporting categories and the reporting infrastructure used to receive performance feedback.

6. Potential payment incentives and penalties

   Describes the article’s comparison to other Medicare pay-for-performance approaches and the broader incentive structure CMS was considering.