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May 11

CMS hoping to track physician use of resources

As reported yesterday by Modern Healthcare’s Daily Dose newsletter DailyDose@ModernHealthcare.com,

The CMS hopes that by mid-2008 it will be able to provide reports to physicians on their use of resources, which can include the services they provide or services they order, such as laboratory work or diagnostic testing, Herb Kuhn, acting deputy administrator of the CMS, told reporters today at a hearing of the House Ways and Means health subcommittee.

In his testimony before the panel, Kuhn said the agency has been investigating ways to measure individual resource use that link quality to the provision of care for beneficiaries and which encourage physicians to focus on efficiency.

Kuhn said the CMS could move forward on this initiative without legislative or regulatory intervention, although it would be beneficial to get Congress’ feedback on measuring resource use.

It will be an ambitious undertaking, he said, considering that nearly 700,000 physicians receive Medicare payments and submit about 800 million claims per year. The agency is currently evaluating commercial and proprietary “episode grouper” software products that assess resource use for an episode of care. “Episode groupers have great promise as a way to organize Medicare data to make meaningful resource use comparisons among physicians,” he said.

In other testimony, Glenn Hackbarth, chairman of the Medicare Payment Advisory Commission, suggested that bundling more services into physician payments would encourage providers to furnish their services more efficiently. Kuhn said bundling works well in hospitals that provide a wide range of services, but doesn’t translate as well to small physician practices.

About Reed Tinsley, CPA

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