Pay for performance is not a trial program, as far as the federal government is concerned.
According to the head of the federal P4P, Thomas Valuck, MD, director of the Special Program Office for Value-Based Purchasing at the Centers for Medicare & Medicaid Services, "pay for performance is not going to cool off any time soon."
Speaking at the Third Annual World Congress Leadership Summit on Medicare May 8 in Arlington, Virginia, Valuck said many doctors think CMS is "dabbling" in P4P and the agency will soon forget about it.
"We're not going to forget about it," Valuck said. "The train has left the station. There will be no turning back."
Currently CMS is offering a voluntary physician P4P program with 74 clinical measures for reporting from July 1 through December 31 this year.
This physician P4P program, known as the Physician Quality Reporting Initiative, is currently focused on "simple P4P," Valuck said. This first stage is "to get doctors engaged in reporting," before CMS increases the measures over time and begins public reporting, according to Valuck.
"If physicians want or need a practice year, this is it," he said.
In 2008, CMS will be offering doctors confidential feedback on their 2007 reporting results in conjunction with bonus payments, Valuck said.
CMS also plans to add patient satisfaction measures in March 2008 and increase incentives for physicians, Valuck said.
CMS's main concern at this point is "trying to figure out how to use pay for performance in the right way." For this, CMS is leaning heavily on pilot programs, said Valuck.
Another element of establishing P4P is encouraging the adoption of healthcare IT, "now and into the future," to make performance results transparent, empower consumers and encourage the improvement in quality of care.
In 2010 CMS plans to begin measuring efficiency and how well doctors are using healthcare IT to advance quality of care, including the use of e-prescribing and registry-based reporting. In addition, CMS will expand P4P reporting to include home health care, said Valuck.
CMS expects to have a report for Congress in June on the current results of the hospital P4P program begun in September 2006 that has so far involved voluntary participation of 98 percent of U.S. hospitals "for a relatively small bonus," Valuck said.