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P4P for Physicians

The Centers for Medicare and Medicaid Services (CMS) announced a new initiative to pay physicians for the quality of the care they provide to seniors and disabled beneficiaries with chronic conditions, reflecting the Medicare Administration’s ongoing commitment to reward innovative approaches to get better patient outcomes for the health dollar.

We intend to provide better financial support for quality care,” said CMS Administrator Mark B. McClellan, “Through this demonstration and the rest of our set of value-based payment demonstrations, we are finding better approaches to doing that than ever before. This is another important step toward paying for what we really want: better care at a lower cost, not simply the amount of care provided.”

As the next step in its efforts to make higher payments for better quality, CMS announced the implementation of a new demonstration aimed at physicians practicing in solo or small to medium sized group practices. CMS has already implemented several other “pay-for-performance” demonstrations, including the Premier Hospital Quality Incentives Demonstration which involves acute care hospitals and the Physician Group Practice demonstration which involves 10 large multi-specialty group practices across the country.

The Medicare Care Management Performance (MCMP) Demonstration was authorized under section 649 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It will be implemented in four states: Arkansas, California, Massachusetts, and Utah in 2007.

A question for home care leaders: With CMS working on P4P for hospitals and physicians, how long do you think it will take to also create a P4P for home care? We’ve heard a lot of talk about P4P for our industry segment. Will it really come soon, and what will it look like? Give us your comments below.

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