A couple of weeks ago, I talked about offsetting the
decrease in payment from the Medicare 2009 Physician Payment
Schedule by participating in the PQRI (in the future through the IC3 quality
improvement program affiliated with NCDR). Ganpat Thakker, M.D., F.A.C.C., governor of the
ACC West Virginia chapter, commented on the post:
“Most of us who reported PQRI measures for 2007 did not get [an] incentive
payment. CMS did not have necessary setup, and there is no appeal option. I am
almost positive that we will not receive any reward for 2008 either.” The
reality is that CMS lacks the capacities to run PQRI effectively -- it is a
crude beginning of a quality monitoring and incentive program. A few of our
larger practices got some actual reward from PQRI, but not many.
My message to all of you exasperated physicians on this topic
is: Think of PQRI as an awkward baby step in the potentially good direction of
substantially increasing payment for improved quality and risk-adjusted
outcomes. I emphasize potentially. We
are advocating to Congress and the payers for real "value" and
quality-improvement reward programs with significant incentives (at least 7 –
10 percent payment increase). We are further working on Congress and insurers
to appreciate the value in using our NCDR systems and the new IC3 quality
improvement program to members and primary care practices to collect and
populate CV performance data. If we, as the profession, are not engaged in
designing and helping to implement quality improvement and reporting programs,
they won’t work.
The ACC applauds all of you who made the effort to
participate in the PQRI, realizing full well that it was as frustrating for
most of you as the Blagojavich Senate seat selection process has been for the
people of Illinois.
But, since quality reporting is coming for certain, at least those of you who
tried to participate are getting ready for the inevitable, and a future program
that will hopefully offer real value to patients and doctors.
Please join the conversation on the topic of quality
reporting and tell us what you think. Don’t
use any four letter words though -- please -- if you’re a PQRI participant. We’re
going to make it better.