WASHINGTON Provider groups are behind the curve when it comes to anticipating acceptance of pay-for-performance programs, Jeff Flick said at a health care congress sponsored by the Wall Street Journal and CNBC.
Take, for instance, the Premier Hospital Quality Incentive Demonstration program funded by the Centers for Medicare and Medicaid Services, under which hospitals report data on 34 quality measures, said Mr. Flick, the CMS regional administrator in San Francisco.
The program gives a bonus each year to the 20% of hospitals with the highest score, but those who have not improved a certain amount after 3 years are penalized, he said.
When the program was launched several years ago, "The American Hospital Association said, 'No hospital is going to do this,'" Mr. Flick said. "Hospitals are afraid to even report information about quality, but the idea that they could be penalized financially … the [AHA] thought it would never happen. But there were 300 hospitals on board immediately."
Similarly, the American Medical Association recently said it did not support CMS's new physician voluntary reporting program, under which physicians would volunteer to report 36 pieces of data on their practices. The AMA's opposition "is not a shock; those kinds of organizations are very nervous about this," said Mr. Flick. "But it is a very important step that CMS is taking, and it is physicians saying, 'I want to report information because I'd like to know if my performance varies in a significant way from my peers.'"
Many physicians are ready to start focusing on quality, he continued. "They want to publish information, they want to know how they compare, they want to be paid based on performance. That doesn't mean the AMA is necessarily going to support it."
The program uses G-codes to enter the data, which can make for a bit of a hassle for physicians not familiar with them. "If every physician in this country had an [electronic health record], this would be easy; I think this would be done," he said. "Today we would be really paying based on performance. Maybe just thinking about the G-codes will drive people into an EHR."