Physician Pay Will Soon Depend on Outcomes

Cheryl Clark, June 13, 2013

The Centers for Medicare & Medicaid Services is seeking feedback from doctors as it builds a model for reimbursing physicians based on actual outcomes rather than process measures.

The e-mail to physicians earlier this month wasn't unexpected. It comes around this time each year when the Centers for Medicare & Medicaid Services invites doctors to tell Uncle Sam how they should be paid.

This time, though, the phrasing of the "Call for Measures" request was different, and from many doctors around the country, I'm sensing a worried cringe.

That's because this time, under authority of the Patient Protection and Affordable Care Act and several ensuing regulations, the payer in chief will move from measuring processes of care to measuring actual outcomes to determine the size of physicians' checks.

"CMS is seeking a quality set of measures that are outcome-based rather than clinical process measures [that] fall into one of the National Quality Strategy (NQS) priorities domains where there are known measure and performance gaps." the agency's message reads in part.

See Also: MGMA: Physician Compensation Increasingly Based on Quality Measures

The deadline for submittals is July 1. CMS will mull them over and in a few months, issue new outcome measures and rules for the Physician Quality Reporting System, adding to or replacing some of the current 328 measures, which largely are processes of care.


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