Quality reporting plan: AMA tells CMS to scrap flawed program

Delegates laud the strong opposition to the voluntary CMS system while pushing hard for dedication to pay-for-performance principles in lobbying efforts.

By David Glendinning, AMNews staff. Nov. 28, 2005.

Dallas -- The American Medical Association earlier this month hit the White House's precursor to Medicare pay-for-performance with a potentially fatal blow before the initiative had even gotten off the ground. Physicians at the Association's Interim Meeting praised what they described as a bold move aimed at protecting doctors' practices.

The entire AMA Board of Trustees signed a Nov. 3 letter condemning the Physician Voluntary Reporting Program, which the Centers for Medicare & Medicaid Services released with much fanfare less than a week earlier. The plan, which would give doctors the opportunity starting in 2006 to report to the government how well they fare on a number of quality measures, is effectively dead on arrival, AMA leaders said.

"We have serious concerns regarding the PVRP and its ability to achieve its stated quality goals," reads the letter to CMS Administrator Mark McClellan, MD, PhD. "The excessive administrative requirements that this program will impose on physicians could doom this initiative and negate any intended quality improvements."

The trustees are calling for CMS to rescind the entire plan and start over, rather than take steps to repair it.

While the voluntary program does not yet incorporate true pay-for-performance, the Bush administration has made no secret of its intention to use the initiative as a springboard for an eventual payment system based on how well doctors score on the quality measures. Following the unveiling of the trustees' letter, delegates passed, with virtually no dissent, a resolution echoing the board's concerns.