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- In July 2007 AMCNO physician representatives and other area health care plans and organizations met with the Medicare Payment Advisory Commission (MedPAC) to discuss private plans usage of episode grouper (pay for performance) software as well as their interactions with and reactions from the physician community. The purpose of the meeting was to provide input into a study coordinated by Mathematica Policy Research with the final study to be provided to MedPAC and the Center for Medicare and Medicaid Services (CMS).
During the interview with AMCNO physician leadership it was made clear to MedPAC that it will be important to inform physicians regarding the parameters to be measured; what tools/software will be needed to provide the information on these measurements and will current systems be compliant; what will physicians need to document to comply, can the program be implemented reviewing a select number of procedures and in a pilot format; will the program be applied uniformly across health insurers and not only the Medicare program, and where will the money come from to pay for this program and will additional costs or reduced payments impact on physician practices. The report also includes research conducted in different areas of the country. To view the complete study entitled “Health Plans’ Use of Physician Resource Use and Quality Measures” go to:
http://www.medpac.gov/documents/Oct07_Phys_Resource_Use_contractor_JP.pdf
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