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Groups Object to CMS Quality Reports Plan

Margaret Dick Tocknell, for HealthLeaders Media, August 8, 2011

Robert Rubino, who is identified only as being from New Jersey, expressed doubt that an agency the size of CMS can react with any speed to new technologies and protocols that may improve the quality of care delivered. “The premise that a government entity that is so poorly run, such as Medicare and Medicaid, can assess quality of care is ludicrous. By the time Medicare recognizes new technology as a standard of care it is often already obsolete. Physicians constantly hone and perfect their care based on peer reviewed journals, shedding old protocols while adopting new ones. The slothful behemoth of CMS could never keep up with them. To simply apply a change in a treatment paradigm on the CMS side would take months or years for it to filter through the bureaucracy.”

Charles Groves, a physician in Indiana, suggested that the rule might mean he could no longer serve some patients. “If I am going to be evaluated by the expense of lab/x-ray/hospitalization costs, then I will need to fire patients with expensive, chronic medical problems.”

The American Association of Orthopaedic Surgeons, which represents more than 18,000 orthopedic surgeons, asked that the experience requirements be strengthened for organizations interested in accessing the Medicare data. “The AAOS believes that qualified entities should have a minimum of five years experience in performance metrics and prior use of Medicare or other payer claims data, not the currently proposed three years. We also believe that organizations should have a concrete plan to furnish data to providers and patients that is reliable, accurate, and actionable.”

In addition, AAOS recommended that providers be given 60 to 90 days to review any reports before they are made public. “We also urge CMS to require qualified entities to supply providers with a more granular report that is easily obtained and can actually be reviewed for discrepancies.”

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