News in brief - March 10, 2008

CMS urges applications for EMR demonstration project - Medicare P4P project offered improved quality but few financial rewards

CMS urges applications for EMR demonstration project

The Centers for Medicare & Medicaid Services on Feb. 20 called on community leaders to apply for a demonstration project featuring Medicare incentive payments for physicians who use electronic medical records. The program will provide payments to as many as 1,200 doctors in the 12 communities to be selected for the program. "We are looking for communities which have strong ties to primary care physicians and are willing to assist CMS in education activities and the recruitment of physician practices," said Kerry Weems, the agency's acting administrator. The project aims to reduce medical errors and improve quality for an estimated 3.6 million patients.

Physicians would receive payments during the five-year project for using certified EMRs to improve quality based on specific clinical measures. Bonus payments also would be made based on a standardized survey measuring the number of EMR functionalities a physician group incorporated into its practice. Total payments under the project could be up to $58,000 per physician or $290,000 per practice.

The application deadline is May 13. Further details are available online in an HHS news release (www.hhs.gov/news/press/2008pres/02/20080220a.html).

Medicare P4P project offered improved quality but few financial rewards

A Centers for Medicare & Medicaid Services pay-for-performance project involving large group practices was reasonably designed and led to quality improvements, but did not financially reward most participants and would be difficult to apply to smaller practices, found a Feb. 15 Government Accountability Office report.

Although eight of 10 participating groups -- each with 200 or more physicians -- met quality improvement targets in CMS' Physician Group Practice Demonstration, only two achieved the required cost savings to earn a bonus. The bonus was $7.4 million for both practices combined. The report said the agency did not provide clearly understood feedback to the practices until the program's third year, which hampered physicians' ability to adjust their care management techniques.

The program, begun on April 1, 2005, uses a hybrid payment formula that adjusts for Medicare enrollees' health status, among other considerations. It is scheduled to continue through March 31, 2009. The report, in pdf, is online (www.gao.gov/new.items/d0865.pdf).

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