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The
powerful American Association for Retired Persons has come
out in support of pay-for-performance (P4P) legislation.
If overwhelming support in the House and Senate wasn't enough
to guarantee passage of a P4P bill, then the AARP's boost
could seal the deal.
Senate
Finance Committee Chairman Chuck Grassley (R-IA) introduced
the "Medicare Value Purchasing (MVP) Act of 2005"
with co-sponsor Sen. Max Baucus (D-MT). "This bill
creates the financial incentives that reward those providers
who deliver that quality care today, and to those who make
improvements where they are needed," Grassley said
on the Senate floor.
The
Grassley-Baucus bill is "an idea whose time has come,"
said John Rother, the AARP's executive officer for policy
and strategy. Using payment incentives to improve performance
will spell better care for older and disabled Americans,
he added.
In 2007,
the Grassley-Baucus bill would give the full payment amount
only to physicians who report quality data, while the rest
would receive a 2 percent cut. And the Department of Health
and Human Services would make that data available to the
public, but not before physicians had a chance to view and
correct the data about them. The Secretary of HHS may make
exceptions to the data-sharing rule based on the size or
specialty of practices.
The
Grassley-Baucus bill would skim 1 percent off the conversion
factor for all physician payments in 2008, and that would
rise by .25 percent per year until it reached 2.0 percent
in 2012 and succeeding years. That money would go to reward
providers who meet a standard established by the HHS Secretary;
or show substantial improvement over the previous year,
according to a standard established by the HHS Secretary.
The
bill provides for the percentage of payments available for
P4P to increase in 2009 and subsequent years. Quality measures
should be evidence-based, vary according to physician specialty
and practice size, include measures of overuse and under
use, include measures relevant to rural areas, and address
the frail elderly and those with chronic conditions.
The
Secretary also would start creating reports on physician
quality, but the reports for 2006 and 2007 would be confidential.
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