Time for another issue of Health Care Reform Primer, and this time we'll get started on Title III, Improving the Quality and Efficiency of Health Care. Subtitle A, Transforming the Health Care Delivery System, is made up of three parts. Today, we'll look at Part 1--Linking Payment To Quality Outcomes Under the Medicare Program.
- The Department of Health and Human Services must create a program under which hospitals that meet certain performance standards can receive value-based incentive payments each year, starting in October 2012.
- Physicians whao fail to satisfactorily submit data on quality measures for their services will see their Medicare reimbursements reduced by 1.5 percent in 2015 and 2 percent starting in 2016. Long-term care hospitals, in-patient rehabilitation hospitcals and hospice programs will also see their reimbursements cut by two percent starting in 2014 if they fail to submit their quality data.
- HHS has the option to make physician participation in a Maintenance of Certification Program and successful completion of a practice assessment part of the quality of care measures on which Medicare reimbursements will be based.
- Cancer hospitals will have to submit quality data starting in 2014, and this data will be available to the public.
- HHS must develop a plan for a value-based purchasing program for Medicare payments to skilled unrsing facilities, home health agencies, and ambulatory surgical centers.
- Starting in 2015, physician reimbursements under Medicare will be modified to reflect the quality of care provided compared to the cost of care.
- Starting in 2015, Medicare payments to hospitals will be adjusted to reflect the rate of health conditions patients acquire during their admissions to the hospital.
Next time: The national strategy to improve health care quality.
Medicare currently pays for health care mainly based on resource consumption and service volume. Payments for treatment of healthcare associated infections and other preventable complications contribute to growing Medicare costs The disconnect between current payment policy and fostering high-quality, efficient care is one reason why the health care share of our nation’s gross domestic product (GDP) continues to increase.
Posted by: Garage Equipment | December 27, 2011 at 10:33 PM
Garage,
The reading I've done on this topic backs you up. Shannon Brownlee's book "Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer" spends a lot of time on this point. If you haven't read that book, I highly recommend it.
Posted by: Tim Dodge | December 29, 2011 at 11:08 AM