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Data Changes the Doctors' Game

Joe Cantlupe, for HealthLeaders Media, August 23, 2012

Physician Feedback reports were mailed to more than 23,000 Medicare fee-for-service physicians in large medical group practices in Iowa, Kansas, Missouri and Nebraska.

The reports detail physician per-capita cost and quality reporting information from 2010 that will be used under what is known as a "value-based modifier" for Medicare pay under the Affordable Care Act of 2010. The modifier is a key to providing different payments to physicians or groups of physicians under a fee schedule based on quality of care compared to costs.

Medicare is required to phase in the payments beginning in 2015 to physicians' groups of 25 or more. The value-based modifier payments would apply to all physicians in 2017.

CMS anticipates that payment incentives and penalties will be based under a proposed rule published July 30 in the Federal Register.  The Affordable Care Act has authorized CMS to penalize physicians who do not participate, up to 2% of allowable Medicare charges, with the same amount as incentive payments.

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