The Quality Measures Increase
Good news for all of you suckers buying into the “quality scam’:
CMS has proposed increasing the number of quality measures used in the Medicare Shared Savings program for accountable care organizations, according to its proposed 2015 Medicare physician fee schedule released Thursday, Modern Healthcare reports. The measures would place an even greater emphasis on patient outcomes. Specifically, the number of quality measures used to assess ACOs would increase from 33 to 37. ACOs would need to meet the quality performance goals to earn bonus payments under the program. The new measures would include:
- Whether patients say providers informed them about treatment costs
- The rate of patients who are admitted to skilled nursing facilities within 30 days of being discharged from a hospital
- Unplanned readmissions for patients with diabetes, heart failure or more than one chronic condition for any reason
In addition, CMS proposed:
- Replacing a measure dealing with medication management;
- Changing a requirement that ACOs adopt electronic health records; and
- Eliminating some measures dealing with treatments for coronary artery disease, diabetes and ischemic vascular disease.
Also in the proposal, CMS suggested adding new quality incentives for ACOs. The incentives would:
- Require ACOs to meet certain quality targets while reducing health care spending in order to receive bonus payments
- Allow ACOs to receive awards based on annual quality improvement
Further, CMS requested comments on future quality measures for:
- Care coordination
- Health outcomes
- Nursing home quality
- Prevention
- Elderly public health
- Utilization
This was all bait-and-switch. They suckered doctors in with a few quality measures and promises of bonuses. First the number of measures keeps going up and then the bonuses go down. Does it matter that there is no proof it helps care?
So, who else wants to jump in the DIRECT PRIMARY CARE world with me? There is a great new EMR system (reasonable monthly rate and make just for DPC) if you want more info. Check it out here.
Good luck with the DPC world. Bureaucratic socialism is not happy when there is a back door. Note that the VA has replaced its senior members with a former president of Procter and Gamble, and a Quality Surfer from the Federal Alphabet Brigade, NQHI or something.
The way to manage what you do not understand is to demand measurement numbers irrelevant to the quality of service, and punish those who do not have the power to change.
Was there really something that romantic about Russia under Brezhnev, that we are racing to reconstruct it?