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CMS to Use Outcome Measures for Physician Pay
In early June, the Centers for Medicare and Medicaid Services (CMS) sent a request to physicians who accept Medicare patients asking for feedback on its plan to develop performance measures based on outcomes—rather than processes of care—for use in its Physician Quality Reporting System. Most of that system's current 328 measures assess whether providers delivered recommended care. The agency will consider proposed measures of clinical outcomes and patient-reported outcomes as well as measures of care coordination, safety, appropriateness, and patient experience and engagement. After considering feedback from physicians, CMS will issue new measures and rules for the reporting system later this year.

Growing Number of Physicians Use EHRs, But Challenges Remain 
A recent Commonwealth Fund–supported survey of primary care and specialty care physicians found that increasing numbers of them are now using a basic electronic health record (EHR)—44 percent in March 2012, up from 34 percent in early 2011. Some 80 percent of physicians use EHRs to view laboratory results, 74 percent order prescriptions electronically, and 67 percent use them to record clinical notes. Smaller proportions of physicians use EHRs to generate patient lists, quality metrics, or provide patients with electronic copies of their health information. Only 10 percent of physicians surveyed met all 11 of the criteria established to demonstrate meaningful use of EHRs, leading the researchers to conclude that providers still face challenges in taking full advantage of EHRs to manage patient populations and improve care.

One of Five Adults Visited an Emergency Department in 2011
Last month, HealthLeaders Media reported on a Centers for Disease Control and Prevention study finding that one of five U.S. adults visited an emergency department in 2011. The study also found that Medicaid beneficiaries, both adults and children, were more likely than the uninsured and those with private coverage to visit the emergency room—suggesting that expansions to Medicaid and other insurance sources under health reform may not curtail emergency department visits, as some have speculated. HealthLeaders also reported on a recent RAND study showing that emergency department physicians are the key decision-makers in nearly half of all hospital admissions. Admissions from the emergency department increased 17 percent from 2003 to 2009—accounting for nearly all of the growth in hospital admissions during that period.

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