GAO Report Questions CMS' Value-Based Physician Pay Program

When it comes to pay-for-performance policies for physicians, CMS can learn from private insurance companies, according to a U.S. Government Accountability Office report.

CMS is moving to implement its value-based payment modifier program, which will reward high-quality, efficient physicians with increased Medicare payment rates. But the GAO questioned the one-year delay before physicians would actually get the extra money under CMS' plan and found private insurers engaging in similar practices keep that turnaround time to seven months or less — a timetable that is likely to have a greater influence on improving physician outcomes, according to the report.

Additionally, the GAO reported physicians tended to prefer group performance measures instead of rewarding individual physician's performance. Physicians also preferred CMS set absolute performance benchmarks to be eligible for the incentives rather than introduce targets that would rank their effectiveness relative to their peers.

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