- The Washington Times - Thursday, November 2, 2006

Measuring quality in the U.S. health care system and giving consumers more information about the services they receive are two goals the Bush administration continued to push this week through a series of payment regulations for Medicare providers.

“We believe consumers deserve a higher level of quality information in health care than anything else,” said Allan Hubbard, director of the National Economic Council and assistant to the president on economic policy.

Starting next year, Medicare will pay physicians more for the time they spend talking with patients about their health care needs, which could result in more face-to-face interaction between doctors and their patients.

“The payment increase should nudge the system toward more personalized care that patients say is the most valuable,” said Rich Trachtman, director of legislative affairs at the American College of Physicians.

To pay doctors more for spending time with Medicare patients, the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees Medicare, has increased a component in the physician payment schedule that accounts for evaluation and management services physicians provide. Evaluation and management services involve understanding the patient’s problems and arranging a care plan to help.

Physicians likely will hesitate to praise the increase because overall they still face a 5 percent payment cut for treating Medicare patients next year. But it is almost a certainty that Congress will step in and avert that payment cut, as they have done the past several years.

The development and implementation of quality performance measures for health care providers became a top priority in the Medicare program under CMS Administrator Mark McClellan, who resigned this year. But the payment rules issued this week signal that Mr. McClellan’s work on measuring the quality of services will continue under acting Administrator Leslie V. Norwalk.

“While our primary focus is on quality care for Medicare beneficiaries, we expect that our quality initiatives will stimulate better care for all patients,” said Ms. Norwalk.

Quality measures can be as simple as giving a patient an aspirin to measuring which hospital gives the patient the best chance for survival.

“CMS is seeking to create a set of quality measures to help consumers understand how a hospital is performing and reward the hospital for reporting the information,” said Carmella Coyle, senior vice president for policy at the American Hospital Association.

CMS announced yesterday that hospitals’ Medicare payment increases will be tied to meeting performance quality measures beginning in 2009. The new performance measures will be developed for outpatient hospitals as well as cancer hospitals, children’s hospitals and rehabilitation facilities.

For the nearly 5,500 inpatient hospitals nationwide, which already have various quality-reporting measures in place, the agency is requiring patient-satisfaction reports. Beginning in 2008, hospitals will be required to inform the government of the results of the patient responses in order to receive an annual payment increase from Medicare.

“Although Mark McClellan has left, CMS is moving full speed ahead with measuring quality in the health care system,” said Alexander Vachon, a health policy consultant for several Wall Street firms. “And patients will be better for it.”

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