Medicare to Accelerate Physician Pay-for-Performance Program

The percentage of physicians' pay tied to quality of care would double in 2016 under draft regulations released by the Medicare program this month, according to a Kaiser Health News report.

The Patient Protection and Affordable Care Act requires bonuses or penalties based on performance for large physician groups by 2015, with quality-based payments and penalties for all physicians who see Medicare patients phased in by 2017. Medicare has determined that physician groups with 100 or more health professionals will gain or lose up to 1 percent of their reimbursement beginning in 2015, according to the report.

Under the new draft regulations, those physician value-based modifiers would increase to a maximum of 2 percent the following year. The proposal would also phase in mid-sized groups containing between 10 and 99 professionals into the pay-for-performance program in 2016 instead of 2017. Mid-sized groups would be eligible for the 2 percent bonuses but shielded from any penalties in 2016, according to the report.

Many physicians would not see their pay altered due to average performance, according to the report. However, the American Medical Association has opposed the program, saying that it would lead to more providers migrating to hospitals and subsequently drive up overall Medicare spending.

More on Physician Medicare Payments:
GAO: CMS Should Keep Closer Eye on Physicians' Self-Referrals
MS Proposes Increased Pay for Physicians Who Manage Chronic Care
10 Obstacles Hospitals Face in Achieving Cost Savings 

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