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:

  1. Whether patients say providers informed them about treatment costs
  2. The rate of patients who are admitted to skilled nursing facilities within 30 days of being discharged from a hospital
  3. Unplanned readmissions for patients with diabetes, heart failure or more than one chronic condition for any reason

In addition, CMS proposed:

  1. Replacing a measure dealing with medication management;
  2. Changing a requirement that ACOs adopt electronic health records; and
  3. 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:

  1. Require ACOs to meet certain quality targets while reducing health care spending in order to receive bonus payments
  2. Allow ACOs to receive awards based on annual quality improvement

Further, CMS requested comments on future quality measures for:

  1. Care coordination
  2. Health outcomes
  3. Nursing home quality
  4. Prevention
  5. Elderly public health
  6. 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.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “The Quality Measures Increase

  1. July 13, 2014 at 9:51 am

    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?

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