AMA asks House: Go slow on pay-for-performance

A longer phase-in would allow Medicare to test quality measures and risk-adjust physician performance results, the Association says.

By David Glendinning, AMNews staff. Oct. 17, 2005.

Washington -- The American Medical Association has asked the sponsor of a House pay-for-performance measure to give physicians more time to transition to the new payment system.

AMA Trustee John H. Armstrong, MD, made the request during a recent hearing before the House Ways & Means health subcommittee, chaired by Rep. Nancy Johnson (R, Conn.). She has authored a bill that would pay physicians starting in 2009 based on how well they meet predetermined quality measures. Giving doctors and Medicare officials an extra year to try out the reporting system at the heart of the proposal would help ensure that it operates in an equitable way, Dr. Armstrong said.

"We would strongly support a greater amount of time for transitioning to a value-based program for physicians' services," he said. "A ramp-up period in 2006, with a phase-in from 2007 through 2010, would allow for proper development of the program."

Johnson's bill, the Medicare Value-Based Purchasing for Physicians' Services Act of 2005, would require the Centers for Medicare & Medicaid Services to approve quality measures next year that would be used to gauge doctors' performances. Full reimbursement updates in 2007 and 2008 would be contingent on whether physicians reported quality data, and 2009 would mark the launch of actual performance-based payments.

Pushing off the effective date of the new payment system to 2010 would give regulators and participants more time to test its components and make sure that the measures are painting an accurate picture of physicians' quality of care, Dr. Armstrong said.