Little is known about how the federal government will operate an incentive program aimed at culling quality data from physician practices.
While it's not clear what the final compromise bill would look like, a summary posted on the Senate Finance Committee Web site only said the bill includes a plan to pay physicians an extra 1.5 percent for reporting "consensus quality measures."
The boost would only apply to Medicare payments between July and December of 2007.
The data collected would be crucial in moving Medicare to a quality-based or pay-for-performance system. Congress may require some sort of pay-for-performance plan for physicians by 2009, observers say.
The Centers for Medicare and Medicaid Services plans to implement the quality data reporting initiative now, said Thomas B. Valuck, MD, medical officer and senior advisor for CMS, at a December 14 Pay-for-Performance Healthcare Webinar.
Valuck said the program will be called "Physician Voluntary Pay for Reporting," and CMS hopes it will mirror similar initiatives in the hospital sector.
"The bill is a very important indicator of not only what we're doing related to that topic, but it sends a signal of how we might be implementing pay-for-performance in the physician setting," he said.
Valuck was vague in responding to questions about what quality measures may be included in the assessment.
While there's no public comment period on regulation selection or other details of the plan, professional organizations are providing advice to CMS on the reporting initiative.
Physician groups are concerned about how much it will cost them to participate in the program and gather required data, said Pat Smith, senior vice president of government affairs for the Medical Group Management Association. He's also uncertain if physicians will believe the stipend - at 1.5 percent on an annualized basis, it represents only 75 cents on a $100 claim - will prod physicians to participate.
Valuck said the additional payment may not be enough to get widespread physician participation. He estimated that data collection costs could represent 7 percent of physicians' Medicare payments.
The eventual form of a pay-for-performance could be a big motivator, he said.
"A bonus of 0.4 percent (in a hospital quality program) motivated most hospitals to volunteer," he said. "Doctors will raise the question of whether this 1.5 percent payment covers their costs."
Public reporting will be an incentive because doctors are competitive, he added.