AMA Assails New Voluntary Reporting Program

▸ Disaster preparedness and response. Delegates called on state and local public health entities to develop a public health disaster plan specific to their locations. National legislation should also be enacted to give qualified physicians automatic medical liability immunity in the event of a declared disaster or federal emergency.

CMS's Reporting Criteria

Thirty-six evidence-based measures are to be reported in the first phase of the voluntary reporting program, according to CMS.

The final measures run the gamut of services, from influenza, pneumococcal vaccinations, and mammography to more complex surgery-related measures, such as prolonged intubation during isolated coronary artery bypass graft procedures. Other measures include the administration of aspirin and β-blockers at the time of arrival for acute MI, and the screening of elderly patients for falls and urinary incontinence.

According to CMS, the performance measures were developed in collaboration with physicians and physician organizations, as well as other stakeholders. Work by the National Quality Forum, the Ambulatory Care Alliance, the AMA's Physician Consortium for Quality Improvement, the National Committee for Quality Assurance, and RAND Corporation “provided the basis for the selection of these measures,” CMS indicated in a statement.

Yet many AMA delegates at the interim meeting said that they felt CMS had “sprung” the program on them at a time when they were facing a 4.4% reduction in Medicare payments.

Michael Barr, M.D., vice president of practice advocacy and improvement at the American College of Physicians (ACP), said that the ACP was discussing its concerns with CMS about the voluntary reporting program, including the fact that not all of the measures had been endorsed by the National Quality Forum.

“This is just the first step of the process” and it is voluntary, CMS spokesperson Peter Ashkenaz pointed out in an interview. “We want to be able to collect information and provide analysis to see how this works.” Ultimately, the goal is to establish a program in which CMS pays for services rendered on high quality of care, not on volume, he said.