PracticeLink Magazine

FALL 2014

The career development quarterly for physicians of all specialties, PracticeLink Magazine provides readers with feature articles, compensation stats, helpful job search tips—as well as recruitment ads from organizations across the U.S.

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Page 90 of 103

FALL 2014 | 91 B oth the government and private sectors are placing increased emphasis on linking payments for health care services to the level of quality of those services. In July, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to add 28 new individual measures to the Physician Quality Reporting System (PQRS)—a program that is required by the Affordable Care Act. At the same time, CMS plans to remove 73 measures from the reporting system, leav- ing a total of 240 individual measures. Generally, physicians who see Medicare patients are required to report only nine measures in three of six quality group domains. The six quality domains, which refect the Department of Health and Human Services' priorities for health care quality improve- ment, are: 1. Patient and family engagement 2. Patient safety 3. Care coordination 4. Population/public health 5. Efficient use of health care resources 6. Clinical process/effectiveness CMS accepted comments on the proposed rule until September. The rule is expected to be fnalized in November and take effect Jan. 1, 2015. Penalties for not meeting goals In the initial phase of the program, the focus is on reporting of data. Physicians who report the required data will receive 100 percent of the allowed amounts of Medicare reimbursements and are eligible for an additional incentive payment equal to 0.5 percent of allowed charges. Physicians (or physician groups) that do not satisfactorily report data in 2014 will have a 2 percent downward adjustment in reimbursement rates for 2016. In future years, penalties will be imposed for not meeting quality guidelines. In 2017, the penalties (referred to in the regulations as "value-based payment modifer adjustments") will increase to 4 percent. The quality indicators, including measure sets for different specialties, are available at (search "measure codes"). In addition to modifying quality measures for By JEFF ATKINSON Linking payments to quality of care Medicare rules and private insurance plans provide incentives for meeting quality goals and penalties for not reaching standards. Reform Recap How health care reform affects your life and practice Continued 2014 ANNUAL Contracts & Compensation ISSUE

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