Wednesday, May 27, 2009
Watch out, bad doctors.
The interest group Public Citizen is launching a new campaign to get hospitals to step up their reporting of physician wrongdoing. Under a federal law, hospitals are required to submit to a database the names of any physicians who have lost their admitting privileges for more than 30 days. However the database has gotten very few reports; more than half of hospitals have never submitted a single name.
So either physicians have been being very, very good, or the hospitals are covering up their wrongdoing. Public Citizen suspects the latter and is urging the Obama administration to crack down on the failure to report. Doc are also on the hook: the organization's press release specifically calls them out for "lax peer review, including a culture among doctors of not wanting to 'snitch' on a colleague."
That's right; snitching isn't just for elementary schoolers and TV characters anymore. Let's hope that the next steps don't involve hair-pulling or cootie-catching.
Labels: quality reporting
posted by Stacey Butterfield at
1:37 PM
0 Comments
Tuesday, March 10, 2009
No performance for peanuts
This time, we're actually talking about doctors, not elephants. A new RAND study (published in Health Affairs) is the latest to assess the impact of pay-for-performance. Participating practices reported increased physician-level performance feedback and accountability, speeded up information technology adoption, and sharpened organizational focus and support for improvement.
BUT, they didn't see the P4P programs having any impact on quality. As researchers told Reuters, that might be because the performance bonuses were too small--about $1,500 to $2,000 per physician annually. "They suggested the incentives needed to be two to five times higher in order to achieve quality improvements."
Sounds like the payers need to find another zero if they want to get everyone's attention. Or just wait for the economic crisis/deflation to make the existing incentives sound relatively appealing.
Labels: pay-for-performance, quality reporting
posted by Stacey Butterfield at
12:46 PM
0 Comments
Thursday, February 26, 2009
Best care doesn't always get best ratings, doc finds
Medicare's Hospital Compare Web site attempts to help the public compare hospitals based on quality of care, but it can also make good doctors look bad, WhiteCoat blogs.
Case in point #1: Docs are required by offical quality indicators to give thrombolytics within 30 minutes of a heart attack patient's arrival. But what if that patient also just suffered a significant head injury? Does the doc try to meet the 30-minute window by skipping the CT scan, thus risking the patient's life if there is internal bleeding? Of course not, says WhiteCoat, but according to Hospital Compare, "my decision made me a bad doctor."
Don't trust everything you read on the comparison site, WhiteCoat concludes.
But how do patients separate the wheat from the chafe?
Labels: hospital medicine, quality reporting
posted by Janet Colwell at
1:02 PM
0 Comments
Monday, December 1, 2008
Ever wonder what people are saying about you on the web?
A new investigation conducted by Slate provides some interesting insight into online physician-rating systems. You know, those things that pop up when you Google a doc and then ask you to "click and pay here" to get all the dirt on him or her. So what's it all worth? Nothing, according to the article. The sites provide almost no information and even less that is useful. But, if you're a doctor with some spare websurfing time on your hands, you might want to try fixing your stats just in case, the author suggests.
Labels: health information technology, quality reporting
posted by Stacey Butterfield at
4:06 PM
3 Comments
Tuesday, September 9, 2008
More kinks in quality reporting
Practice managers are reporting more trouble with the Physician Quality reporting Initiative (PQRI) results, citing a lack of data, administrative burdens, and an 18-month delay in learning results.
Nearly 70% reported low or no satisfaction with how the program's results improved patient care outcomes. Nearly 93% reported problems accessing their results, according to a survey conducted by the Medical Group Management Association.
Specific complaints cited by the MGMA survey include the lack of data for improving patient outcomes and difficulty accessing and downloading the 2007 feedback reports. On average, respondent practices spent five hours downloading their final 2007 PQRI feedback reports from the Web site. In addition, 63% of respondents reported difficulty capturing and submitting data.
ACP members had previously reported their own difficulties. ACP is collaborating with a survey being conducted by the American Medical Association to assess physician experience with PQRI to further bolster arguments that Medicare needs to improve the program quickly. Look for details in upcoming issues of ACP InternistWeekly.
Labels: quality reporting
posted by Ryan DuBosar at
9:47 AM
0 Comments
Thursday, August 21, 2008
Working out the kinks of quality reporting
Medicare released its first round of bonus payments to physicians who reported quality care data. But physicians say the actual payouts are relatively small and might not be worth the record-keeping, and report problems learning how well they performed.
The Centers for Medicare and Medicaid Services (CMS) introduced the Physicians Quality Reporting Initiative in July 2007. The program awards a bonus payment of 1.5% of allowed charges for Medicare patients to physicians who submitted quality measure codes. Since then, between 10 and 15 percent of internists reported at least one quality measure code, and slightly more than half earned a bonus. ACP will report more specific outcomes to members in the near future.
Internist William E. Fox, FACP, an internist in Charlottesville, Va., writes that his practice received a bonus payment below the average amount that Medicare had reported. He said that's probably because his practice is four years old, with a smaller patient panel and fewer Medicare patients.
But established internist W. James Stackhouse, MACP, of Goldsboro, N.C., received his bonus payment and questioned if it's worth continuing participating, even using simplified alternative reporting shortcuts that were released this year. He writes, "It took a lot of paperwork and screwed up billing because we had to charge 1 cent per code so that the Medicare carrier's computer would pick up the charges, and then had to manually write off that charge afterward."
His back-of-the-envelope math estimates a physician could reasonably recoup $6,000 in bonus payments, "which represents an extra 99213 visit only about 120 times in year, or about one every other day of office hours." He added that's little motivatation for the extra record-keeping.
Also, physicians who participated in the 2007 PQRI are supposed to be able to find out how they performed on a secure Web site. However, Dr. Fox has been so far unable to access his reports, a complaint voiced by users during a public forum CMS conducted, according to ACP's Regulatory and Insurer Affairs staff. Since doctors who have a bad first experience may not continue, ACP is reporting its members' frustrations back to Medicare.
Dr. Fox asked, "I wonder what results others have had?" ACP is working with the American Medical Association to survey internists about their experiences, as detailed in a report here.
Labels: quality reporting
posted by Ryan DuBosar at
10:00 AM
3 Comments
ACP Internist hosted Grand Rounds on June 16, wrapping up the best of the medical blogosphere. Click here for the complete wrap-up.
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EverythingHealth is designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
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Michael Benjamin, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.
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