First posted on The Hospitalist Leader on 8/5/2012
CMS is overseeing a physician initiative in four states, and you likely know little about it. Additionally, you are probably unaware of the program it seeks to inform.
In 2015, Medicare will begin to assess physician performance on cost and quality data. Through a value-based code, our newly adjusted fees will reflect these measurements, relative to our peers—with the intent of raising the care delivery bar at the doctor level. The public will have also access to this information.
Here is the very concise, one page primer on the program. Some physicians in Kansas, Iowa, Missouri, and Nebraska now receive these report cards.
One issue for hospitalists, and other hospital-based groups (ER, ICU, radiology), is the correct level of analysis and the tradeoffs involving each option. Choosing valid process or outcome measures is a topic for another day.
Nothing is certain, and professional societies like SHM have an opportunity to inform CMS on the approach that works best. Selecting wisely will ensure we balance public and HM interests, understanding compromise is necessary.
The following is my take on the options:
The issues of risk adjustment, episode grouping, data turnaround (2015 compensation reflects 2013 practice), correct physician attribution, etc., are unsolved and controversial. Above is only step one, but a big one. Most hospital-based practitioners will prefer a group analysis, but CMS will nudge (longer-term) towards the hospital slant given its goal of cultivating population health.
What is your opinion?
PS–Here is a good 5-minute video on the VBP program from Kaiser Health News. Worth it! Also, the Washington Post story from the same reporter (Jordan Rau, who is top-notch btw, and works the inpatient beat).