"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Thursday, July 25, 2013

CMS to Link Physician Pay to Quality

Finally, CMS is beginning to align incentives between providers.  Right now, WMHS is paid on a value-based care delivery system, while many of our physicians continue to be paid based on volume.  As of 2015, physician pay for those physicians working in large groups (100 or more) will have a portion of their pay at risk.  They will get bonuses or be penalized.  It looks like our physicians who are in mostly small practices (less than 9) will have to wait until 2017. 

The program will be similar to the Quality Based Reimbursement program in Maryland based on a zero- sum game.  There will be winners and losers since there is no new money for the bonuses.  Through our President's Clinical Quality Council, we have been working with our physicians to get them to understand how the QBR program works and impacts us.  The intention has been to better prepare them for what's on the horizon with CMS's Pay For Performance (P4P) plan.  Under the CMS P4P plan, quality measures for physicians will be based on basic medical approaches, and initially physicians will get to pick the measures by which they want to be judged.   I realize that many physicians are not excited about the new pay plan, but it is a start in getting all providers aligned with each other.  Stay tuned.

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