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Senate Bills Would Reform QIO Program
This month, Senators Hatch (R-UT), Rockefeller (D-WV), Lott (R-MS), and Kennedy (D-MA) introduced a bill designed to strengthen the Medicare Quality Improvement Organization (QIO) program.

Currently, there are 53 QIOs working in the states and U.S. territories, providing assistance with health care quality improvement techniques to providers, practitioners, and public and private health plans and purchasers. Sponsors of the reform bill say that existing QIO legislation, created in 1982, does not reflect the organizations' current roles in promoting quality measurement, quality improvement, and public accountability in health care.

The proposed legislation would focus the QIO program on the following core goals: reducing health care disparities, improving rural health quality, strengthening coordination of care, supporting the adoption and use of health information technology, assisting providers in measuring and publicly reporting performance, and informing health care consumers of their rights.

This action follows the introduction of another bill aimed at overhauling the QIO program, the "Continuing the Advancement of Quality Improvement Act of 2007," by Senators Grassley (R-IA) and Baucus (R-MT) in August. The Grassley-Baucus bill would create a Medicare Provider Review organization to review beneficiaries' complaints about the quality of care they receive and report the results of these investigations back to beneficiaries. Currently, QIOs are charged with beneficiary complaint review.

CMS Pilot: Higher Payments for HIT Use
In late October, the Centers for Medicare and Medicaid Services announced that it will recruit 1,200 physicians to implement health information technology (HIT) systems in exchange for higher Medicare payments. Under the five-year pilot program, physicians will use HIT to order prescriptions, document lab test results, and perform other tasks; the more aggressively physicians use HIT, the more they stand to gain in increased pay.

Participating physicians must use electronic health record systems that have been approved by the Certification Commission for Healthcare Information Technology, an independent certification organization.

Currently, only about 10 percent of doctors in solo or small-group practices use HIT.

Many argue that widespread use of HIT could control health care costs by streamlining care processes and avoiding errors and redundancies. But Peter Orszag, director of the Congressional Budget Office, warned recently that the evidence thus far shows that the cost-cutting impact of electronic health records "is not going to be as substantial as people think."

Hospitals, States Target Infections
A new survey from Premier, a hospital consortium, found that more than 22 percent of hospitals are using an automated system to help monitor and control infections. This reflects a 9 percentage point rise in the use of surveillance for hospital-acquired infections from February to October 2007.

This month, New Jersey Gov. Jon Corzine (D) signed into law a bill requiring hospitals to publicly report nosocomial infection rates. New Jersey hospitals will file quarterly reports to the state health department on their nosocomial infection rates and the measures they have taken to control infections, and the health department will post this information on its consumer Web site. Supporters of the bill maintain that it will encourage hospitals to adopt best practices to prevent infections.

Nineteen other states also require hospitals to report infection rates, though not all of the reports are public.

Minnesota Physician Group Ranks P4P Programs
This month, the Minnesota Medical Association published a report evaluating the state's pay-for-performance (P4P) programs. The association rated the effectiveness of nine P4P programs, operated by health plans and government programs, according to their ability to: drive quality improvement, strengthen the patient–physician relationship, include physicians across medical specialties, and use valid measures of performance.

According to the report, the incentive program run by the federal Centers for Medicare and Medicaid Services is most effective, while Bridges to Excellence, a program used by large, self-insured employers, is the least effective.

The report urges Minnesota's health plans, employers, and others to take the following steps to improve P4P programs:
  • adopt a common measurement set and a streamlined data collection process;
  • provide financial incentives for care coordination, especially for patients with chronic illnesses;
  • provide financial incentives for implementing health information technology and electronic medical records;
  • eliminate financial penalties for providing care that is in the patient's best interest; and
  • ensure that programs don't penalize physicians who accept patients with complex and difficult conditions.
WellPoint and Zagat to Offer Physician Guide
One of the nation's largest health insurers, WellPoint, is joining with the restaurant and entertainment reviewer, Zagat Survey, to develop an online physician ratings guide. As in Zagat's popular restaurant guides, the physician guide will feature reviews and ratings from consumers, not experts. Patients will grade their physicians on a 30-point scale based on their performance in four areas: trust, communication, availability, and office environment. The guide will also include patients' verbatim comments about particular physicians.

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