Medicare Announces Plans to Accelerate Linking Doctor Pay to Quality

The government, in a draft rule, says it will double the penalties and bonuses offered some group practices with 100 or more professionals. It also moves up deadlines for practices with 10 professionals.

Re-posted from Everyday Health    |     By Jordan Rau, Kaiser Health News

MONDAY, July 22, 2013 (Kaiser Health News) — But the provision regarding doctors is considered the most complicated to enact, and it has encountered strong pushback.

Major physicians groups have been pushing Congress to repeal it, while some health policy experts fear the amount of money Medicare plans to use for incentives will be too small to prod doctors to improve their patient care.

Medicare had already decided that large physician groups — those with 100 or more doctors, nurses, social workers or other health professionals — will gain or lose as much as 1 percent of their pay starting in 2015. Those incentives would double to 2 percent the following year under draft regulations Medicare released this month.

The proposal also would phase mid-sized physicians groups—those with between 10 and 99 health professionals—into the program in 2016 instead of in 2017. While they would be eligible for bonuses up to 2 percent, they would be shielded from any penalties for that first year.

In 2017, the program would add the remaining doctors in practices of nine or fewer professionals— about 350,000 doctors, according to Medicare’s estimates.

Pay for many doctors would likely not be altered because their performances were average, although Medicare hasn’t announced exactly how it will dole out bonuses and penalties. There have to be financial losers in the program, because the health law requires that the program not increase the budget deficit….MORE

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