Pay for Quality, including MCMP and PQRI
The need to improve the quality of patient care for chronically ill Medicare beneficiaries has never been greater. The Centers for Medicare & Medicaid Services has established the “Medicare Care Management Performance (MCMP) Demonstration, a 3-year pay-for-performance pilot program with small and medium sized physician practices to promote the adoption and use of health information technology, as a tool to improve the quality of patient care. Physicians who meet or exceed the performance standards established by CMS in clinical quality performance will receive an incentive payment for managing the care of eligible Medicare beneficiaries. Physician practices that are able to report data electronically to CMS will be eligible for an additional incentive.
Under this demonstration, physicians will continue to be paid on a fee-for-service basis. Participating physicians will submit data annually on up to 26 quality measures related to the care of patients with diabetes, congestive heart failure, and coronary artery disease, as well as the provision of preventive health services, such as immunizations and cancer screenings for high risk patients with a range of chronic diseases. A complete list of measures is available at http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/list.asp.
As one of only four pilot states selected for the MCMP program, Massachusetts physicians currently enrolled in the CMS Doctor’s Office Quality-Information Technology (DOQ-IT) project will be eligible to apply for participation.
As the Quality Improvement Organization (QIO) for Massachusetts, Masspro will enroll and engage a core group of 250 DOQ-IT physician practices into the MCMP demonstration. Masspro will assist these practices in implementing electronic health record (EHR) technology and care management strategies. Masspro will also assist the MCMP practices in reaching program milestones.
Additional information for this demonstration can also be found in the attached Frequently Asked Questions (FAQ) document.
Physician Quality Reporting Initiative
President Bush authorized the establishment of a physician quality reporting system on December 20, 2006 by his signing of the Tax Relief and Health Care Act of 2006. Title I, Section 101 authorizes CMS to establish this system, which they have entitled the 2007 Physician Quality Reporting Initiative (PQRI). PQRI establishes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals* who successfully report a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007, may earn a bonus payment, subject to a cap, of 1.5% of total allowed charges for covered Medicare physician fee schedule services. To learn more about PQRI, please visit the official CMS PQRI website at http://www.cms.hhs.gov/pqri for program details or contact Trish Manning, Health Information Systems Advisor, Masspro at 781-419-2892 or pmanning@maqio.sdps.org.
For clarification on "eligible professionals" please visit http://www.cms.hhs.gov/PQRI/10_EligibleProfessionals.asp
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