IOM To Recommend Improvements In End-Of-Life Care; Physicians Slow To Report Quality Measures To Medicare

Two articles examine different efforts to improve medical care.

San Jose Mercury News: National Institute Of Medicine Will Recommend Ways To Improve End-Of-Life Care
In a national move that portends improvement of care for the dying, an expert panel assembled by the Washington, D.C.-based Institute of Medicine announced Thursday that it will recommend ways to improve end-of-life care in America. The Institute, part of the prestigious National Academy of Sciences, seeks changes in federal policy, financing and hospital practices that will bring care into line "with individual values and preferences to promote high-quality, cost-effective care at the end of life," according to a statement (Krieger, 1/10).

Medscape: Physicians Must Hustle To Avoid Reporting Penalty
Introduced in 2007, (Medicare's Physician Quality Reporting System) gives clinicians cash bonuses for telling the Centers for Medicare & Medicaid Services (CMS) how they score on clinical measures such as the percentage of final fluoroscopy reports that document radiation exposure or exposure time or the percentage of adult patients with diabetes whose most recent hemoglobin A1c reading exceeds 9%. Clinicians choose a handful of measures to report from a menu of several hundred. At least for now, it is pay-for-reporting, not pay-for-performance, which involves meeting certain score thresholds. The average individual bonus in 2010 was $2157. In 2015, the cash bonuses are replaced by a penalty equal to 1.5% of Medicare charges, which CMS will impose on physicians and other clinicians who do not successfully report quality data for 2013. The article projects that average penalties for radiologists in 2015 will range from $1991 for diagnostic radiologists to $6029 for radiation oncologists. ... What lends extra urgency to this warning are the low rates of participation so far in PQRS (Lowes, 1/10).

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