|
|
 |
Quality Improvement and Pay for Performance
current newsImprove Drug Safety for Your Medicare Patients in Texas Information courtesy of TMF Health Quality InstituteDrug-related problems are common in older adults. Senior patients often see several physicians, all prescribing different medications, and communication is not always what it should be. As part of a contract with the Centers for Medicare & Medicaid Services (CMS), TMF is offering to Texas physicians, at no charge, quality improvement assistance for increasing drug safety for Texas Medicare patients. “Elderly patients are often prescribed multiple medications, increasing the possibility of adverse drug interactions. They also may have health conditions that make the use of certain drugs problematic,” says Jim Turpin, TMF Health Quality Institute® pharmacy quality improvement consultant. The Part D Drug Safety Project, sponsored by CMS, is a Texas initiative that has two components. One component targets potentially inappropriate medications (PIMs) including specific narcotics, antihistamines and skeletal muscle relaxants that may lead to falls and fractures in the elderly. The second component targets warfarin and amiodarone as a “high risk” adverse drug on drug interaction (DDI) that is preventable. read more Medicare Pay-for-Reporting Program Starts July 1 The ACP Practice Management Center (PMC) has released preliminary guidance on Medicare’s upcoming pay-for-reporting program, the Physicians Quality Reporting Initiative (PQRI). The Medicare PQRI Medicare will begin on July 1, 2007 and run through December 31, 2007. The program was established under a federal law enacted in December 2006. Under the PQRI, CMS will pay physicians for reporting on specified quality measures. Internists will need to successfully report on three of 74 different quality measures to receive the 1.5% bonus to their Medicare payments. Physicians do not have to register in advance for the program, just include the applicable quality measure code on the same claim form used to bill the Medicare service. CMS will know which physicians are participating in the voluntary program when it processes the claims. As CMS releases further details about the program, the PMC and ACP will provide additional information related to the PQRI—information describing the program and information aimed at helping interested members to participate with minimal burden. PMC’s publication is available to registered ACP members (PDF link) and more information on the PQRI from CMS is online (link). The quality of health care has become an issue of increasing interest and concern among physicians and health care managers. The Institute of Medicine reported that problems in health care quality are serious and extensive, and that several health care systems have succeeded in improving the quality of care for specific patient groups. Quality problems in our health care system endanger the health and lives of patients, add costs to the health care, and reduce productivity. Besides, the wide variations in the cost of care with no apparent relation to the quality of care have driven purchasers, health plans, and policy-makers to look for ways to get more value from the health care dollar. read more The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. read more Definition of Quality Improvement Quality improvement is a team effort of identifying opportunities for improvements, measuring performance, and involving the frontline providers and staff members to find ways to improve performance. Quality improvement goes through repetitive cycles of measuring performance, testing change concepts and then re-evaluation of outcomes measures. read more Institute of Medicine (IOM) Six Aims for Improvement
Pay for performance (P4P), or value-based purchasing, is defined as creating a direct link between what purchasers spend on healthcare and the value of services provided. The goal of Pay for Performance is to create a compelling set of incentives that will drive breakthrough improvements in the quality of health care and the patient experience. "Pay-for-Performance" programs can improve both medical care and quality of life by giving health care providers a financial incentive to seek measurable improvements in the health of their patients. P4P encourages physicians and healthcare institution to practice evidence base medicine and creates a system that encourages and support physicians to implement the best practices (reference: CMS Physician Quality Reporting Initiative). Why do we need Pay for Performance? The problem is that health care today is characterized by more to know, more to manage, more to watch for, more to do, more people involved in dong it than any time in the nation’s history. Quality problems do not stem from a lack of knowledge, training or efforts by heath professionals. No unaided human being can read, recall, and act effectively on the volume of clinically relevant scientific literature”. That is why we need a system that encourages evidence base medicine and helps physicians implement the best practices. P4P aims at measuring physicians in an objective way and rewarding high performers in a fair manner (Reference: IOM, Crossing the Quality Chasm, 2001).
Home
|
About
|
News
|
Members Only
|
Preceptorship
|
Advocacy
|
Career Center
|
Annual Meeting
|
On Being a Doctor
|
Associates
|
Medical Students
|
FAQ
|
Practice Management Center
|
Quality/P4P
|
Links
|
Calendar
|
Site Map
|
Contact Us
|
