tci Medicare Compliance & Reimbursement - 2004 Issue 45

Pay-For-Performance: MedPAC Continues Its Push On Pay-For-Performance

How long until providers are paid based on quality?  What Medicare will do is still unknown, but the Medicare Payment Advisory Commission - and a growing number of private payers and health insurers - are making a strong push to move forward with pay-for-performance systems. In a P4P scheme, some of an individual physician's or group practice's payment is based on the quality and efficiency of care provided. Data profiling physicians' style of care provides the information basis for such efforts.MedPAC, which advises Congress and the Centers for Medicare and Medicaid Services on payment issues, is...

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