What's Up with Voluntary Reporting? - Part 2
PVRP Is the Future
Dr. Siegal—and many others—believe that the PVRP will evolve into a broader reporting program and will ultimately transform into a mandatory pay-for-performance system for CMS. This may happen faster than CMS usually moves.
“Eventually there will be money tied to this,” he says. “Rumors are that payment modifiers may be tied to reporting as early as the fourth quarter of this year. As things go in the federal government, the evolution to value-based purchasing is moving at a lightning-fast pace—CMS is actually getting pushback from medical groups for moving too fast.”
Dr. Siegal adds that, “CMS is very interested in engaging physician organizations for their input. [CMS Administrator Mark B.] McClellan has done an admirable job of making this an interactive process.”
As PRVP evolves, it is likely to become more applicable to hospitalists.
“This is all part of a larger evolutionary trend in medicine,” explains Dr. Siegal. “Currently, hospitals and physicians are treated separately by CMS, and paid and incentivized differently. There’s growing realization that with rising costs and increased need for quality improvement hospitals and physicians need to have their incentives aligned. Things are going to change and it will take a long time for this to shake out.”
Because PVRP is the wave of the future for CMS payment, Dr. Siegal believes that hospitalists will be better off if they join in now. Voluntary reporting requires hospitalists to develop a new reporting infrastructure, and, as he says, “It’s better to do that now, with only 16 measures, than to have to do it later when there are 36 or 42.”
Dr. Siegal is convinced that hospitalists should support PVRP now, in its first stage. He also believes that SHM will begin to get involved. “We clearly need to be at this table,” he emphasizes. “Hospitalists are going to be the dominant providers of care to hospitalized Medicare patients. That said, SHM is still a relatively small society, and we don’t have the resources to engage every aspect of this debate. This is a huge and complex issue and SHM needs to use its limited resources wisely.”
SHM’s Public Policy Committee will continue to monitor what happens with PVRP and CMS, and SHM may eventually pursue membership in the national quality forums that are developing new metrics.
CMS provides details on the PVRP, including instructions on how to sign up, on their Web site at www.cms.hhs.gov/PVRP/01_Overview.asp. TH
Jane Jerrard regularly writes the “Public Policy” department.
