It’s hard not to look at Medicare Reform as a zero sum game: any gain for the administrators of the program is a loss for the patients seeking medical care. That being the case, score 1 for Medicare patients in the Mid-West, where Reform ties physician payments to patient quality of care. Indeed, the more a physician controls costs and avoids hospital stays, the better rating his/her team will receive. This rating corresponds directly with the amount of money paid to them for services. Details of this Medicare Reform are clearly indicated in this article written by Jordan Rau for the Washingtonpost.com:
Medicare Reform Ties Physician Payment to Patient Quality of Care
Twenty-thousand physicians in four Midwest states received a glimpse into their financial future last month. Landing in their e-mail inboxes were links to reports from Medicare showing the amount their patients cost on average as well as the quality of the care they provided.
“It may be the most difficult measurement challenge in the whole world of value-based purchasing,” said Dr. Donald Berwick, former administrator of the federal Centers for Medicare and Medicaid Services, or CMS. “We do have to be cautious in this case. It could lead to levels of gaming and misunderstanding and incorrect signals to physicians that might not be best for everyone.”
Dr. Michael Kitchell, a neurologist and chairman of the board at the McFarland Clinic in Ames, Iowa, one of the state’s biggest multi-specialist practices, predicted the Medicare reports “will be a huge surprise to almost every physician.” That’s because the calculations of how much those doctors’ patients cost Medicare include not just the services of the individual doctor but of all the doctors that provided any treatment to the patient. Kitchell said his patients saw on average 13 physicians besides himself. Original Article Here.
The new plan for Medicare reform ties physician payment to patient quality of care. It seems promising and is a significant step towards controlling Medicare Costs. One major challenge will certainly relate to measuring the quality of care provided by the physicians. Who determines their rating and how is that rating applied? Eventually doctors will come around if the rating are seen as fair and unbiased. It will be interesting to see how this system develops in other states.