GOVERNMENTCMS team takes aim at physicians' Medicare beefsThe group checks off several items on its list of doctor complaints and eyes new challenges.By Markian Hawryluk, amednews staff. Jan. 7, 2002. Washington -- Its issues aren't as glamorous as Medicare reform or a payment update fix, but an internal team at the Centers for Medicare & Medicaid Services is making concrete gains in its effort to reduce everyday hassles for practicing physicians. The Physicians' Regulatory Issues Team was born out of complaints that physicians face an extraordinary volume of complex Medicare regulations. PRIT initiated the Physician Issues Project, the identification of the 25 issues most often cited as getting in the way of physicians trying to provide care to their patients. The Practicing Physicians Advisory Council, a panel of doctors that advises CMS, chose seven of those issues as top priorities. "These are major problems," said Douglas Wood, MD, a Rochester, Minn., cardiologist who serves on PPAC. "They're ones that, if resolved, would help the people who take care of patients on a daily basis and would help to remove some of the barriers to good patient care." Much of the progress in achieving at least partial resolution of those priorities has been attributed to Barbara Paul, MD, PRIT director and CMS medical adviser. "In February, I indicated that I thought that by the end of the year, physicians would see some tangible improvements in the program," Dr. Paul said. "I'm hoping that physicians are beginning to see some of those. We've been working hard to identify issues, chase them down, and create solutions that are truly tangible to the practicing physician." PRIT has helped CMS streamline its requirements for certificates of medical necessity, the reordering of supplies for diabetics, and the ordering of laboratory tests. It has taken steps to reduce carrier denials for preoperative screenings and follow-up visits with cancer patients. And its work has led to greater clarity and simpler forms for issuing advance beneficiary notices. Dr. Wood thinks the greatest disappointment has been that limited resources in the agency have kept PRIT from tackling more than a small number of the issues that physicians identified as being important. The regulatory changes notwithstanding, PRIT's greatest success may be in changing the attitude among CMS staff towards physicians. "I think there are some signs that there's a change in the view of the agency, including some of its staff members, to really aim more at service improvements." Dr. Wood said. Dr. Paul agrees. The physicians issue project, she said, has served as something like the FBI's Ten Most Wanted List, bringing a greater sense of purpose and urgency to the issues. "Going back looking at the incoming testimony and input that we had received at the agency in the prior year or two, and putting them all together in one place and one document to share with staff at the agency, has been very effective in amplifying the voice of physicians inside the agency and raising their concerns up the chain of command and getting resolution," she said. That hasn't been lost on physicians such as Stephen Imbeau, MD, a Florence, S.C., internist and a PPAC member. "The agency, at least in part, is saying, 'We want to resolve hassles, and we want to listen to physicians.' " While there are no "moon shots" on the PRIT list of accomplishments, Dr. Imbeau said, that doesn't diminish its work. "It's a bunch of small shots that add together for a good thing," he said. He points to moves such as restoring Medicare's help lines to 24-hour service and instituting monthly conference calls with physicians. He credits PRIT and Dr. Paul with shifting the discussion about program integrity from punitive approaches to educational efforts. "In all those ways, they're starting to put a different face on the agency," Dr. Imbeau said. A low profileWhere PRIT has perhaps come closest to failing is in letting physicians know of its progress. "I doubt the rank and file know much about PRIT," Dr. Imbeau said. Most doctors see their local carrier and the carrier medical director as Medicare, he said. Dr. Paul and other CMS officials have made a greater effort to communicate with physicians, both to gather and disseminate information about the PRIT program. They are frequent visitors at state and specialty medical society meetings and have arranged for a number of CMS staff to shadow clinicians for a day or longer to get a better understanding of a physician's daily environment. But Dr. Paul said it's extremely difficult for an agency of only 4,700 employees administering programs the size and scope of Medicare and Medicaid to communicate with more than 800,000 physicians nationwide. "It's an enormous challenge for an agency this small," Dr. Paul said. But Dr Paul believes PRIT will have many more successes to communicate to physicians this year. "I think we can say that we've crossed a number of things off the list already, and I aim to cross a few more off the list in the next few months," she said. The next phase of PRIT's work will likely not focus on a formal list of projects but on creating a "culture of responsiveness" to deal with problems as they arise, Dr. Paul said. PRIT's future may also be tied in with a new Government Reform Advisory Council, created by Health and Human Services Secretary Tommy Thompson to identify potential reforms across the department. "I think that PRIT and the physician issues project will be the implementing arm of some of the recommendations of the secretary's task force," Dr. Paul said. Accomplishments and goalsTo date, PRIT has focused on these seven high-priority issues:
ADDITIONAL INFORMATION:How to navigate MedicareLooking for answers to Medicare questions? Have a complaint about a Medicare policy? The Centers for Medicare & Medicaid Services' Physicians' Regulatory Issues Team suggests the following ways to contact the program:
WeblinkPhysicians' Regulatory Issues Team (http://www.hcfa.gov/medlearn/prithome.htm) Copyright 2002 American Medical Association. All rights reserved.
|
Featured stories     
« Prev
1
2
3
4
5
6
Next »
Current topicsMost-viewed
This weekUnspent war funds eyed to avoid years of Medicare doctor pay cuts Rite Aid clinics place new twist on "doc-in-a-box" Get our email alertsUse our one-step registration. Learn more Your information will not be shared. Privacy policyColumns and series
From the vaultQuotable"Our goal really is to provide the right care for patients at the right time. Not too much and not too little." Steven Weinberger, MD, co-author of a list developed by the American College of Physicians of 37 clinical situations in which screenings and medical tests provide little or no benefit |
|||||||||
SHARE
