According to a recent Kaiser Health News article, Medicare will soon link physicians’ payments to the quality of care they provide. The federal Affordable Care Act requires large physician groups (those with 100 or more health professionals) to receive performance-based bonuses or penalties no later than 2015. All Medicare-certified physicians will be phased into the program by 2017.
The new performance-based program is an attempt to shift Medicare away from its traditional fee-for-service system, in which physicians are paid based on the services they provide, irrespective of their performance. Proponents believe that the current system incentivizes physicians to perform more procedures, escalating health care costs.
Opponents, including several major physicians’ groups such as the American Medical Association (AMA), are urging Congress to eliminate the program. Click here for a letter the AMA wrote to the House Ways and Means Committee in April.
According to the article, Medicare officials will calculate the bonuses and penalties based on quality measures that vary across specialties as well as each physician’s average patient costs. Initially, physicians will be able to choose which Medicare performance measures they want to be assessed by. According to draft Medicare regulations, large physician groups will gain or lose up to 1% of their pay in 2015, and up to 2% in 2016.
