Outpatient Facility Coding Alert - 2004 Issue 43
Pay-For-Performance: Quality Is Job Two, After Figuring Out What 'Quality' Means
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Article Overview
This article discusses how Medicare and CMS were exploring pay-for-performance strategies for physician practices, with attention to different ways quality could be measured and rewarded. It is relevant to physicians, medical practice administrators, compliance staff, and health policy readers interested in quality measurement, health information technology, and incentive-based payment design. The article also covers a CMS demonstration project, stakeholder concerns about reporting and privacy, and the broader policy effort to define and support physician quality improvement.
Why This Topic Matters
It helps readers understand the policy direction behind physician incentive programs and the operational issues that can affect participation, including technology adoption and compliance concerns.
Article Sections
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Performance Measurement Approaches
Describes broad categories of physician performance measurement considered in Medicare payment policy. The section discusses how quality could be evaluated using different types of indicators and program designs.
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What Can CMS Do To Help?
Summarizes CMS efforts to support physician offices through information technology, quality improvement resources, and incentive-based programs. It also introduces a demonstration project and concerns raised by physicians about participation.
What You Will Learn
- The general types of physician quality measures being considered in pay-for-performance policy
- How Medicare and CMS were thinking about incentives for quality improvement and health information technology
- Why physician groups raised concerns about privacy, liability, and compliance when participating in quality programs
- How a CMS demonstration project fit into broader quality measurement efforts
Who Should Read This
- Physicians
- Medical practice administrators
- Compliance professionals
- Health policy analysts
- Quality improvement staff
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