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You Want Measures? We've Got Measures

By John Reichard, CQ HealthBeat Editor

Nov. 28, 2006 -- The American Medical Association said Tuesday that it's got the quid in the quid pro quo, and now it's time for Congress to come up with the dough. The physicians lobby released a letter mailed earlier this month to incoming House Ways and Means Committee Chairman Charles B. Rangel noting that physicians have now developed 150 quality-of-care measures and are asking his help in erasing a 5 percent cut in Medicare payments to doctors starting Jan. 1.

"The physician community has not shied away from developing new quality measures per our agreement with congressional leaders, and we hope Congress does not miss the opportunity to address the cuts facing physicians and their patients," AMA Executive Vice President Michael D. Maves wrote Rangel, a Democrat from New York. "We have fulfilled our promise to create new physician performance measures that will become the foundation of a new reporting regime that will lead to improved quality in the Medicare program."

Rangel has said he would like to see legislation passed this year erasing the scheduled cut but that he didn't know where the money would come from. Congressional GOP aides see a chance that lawmakers will vote to erase the cut when they return the week of Dec. 4, but also warn that finding money to pay for such legislation will be difficult.

Maves said half of the nation's doctors are facing a cut of more than 5 percent because of factors other than the physician payment formula. Imaging cuts mandated by the budget savings law (PL 109-171), expiring geographic adjustments in Medicare physician payment, reassignments of "value scores" for different types of physician care, and changes in payments for expenses incurred by physician practices also affect many doctors, according to Maves.

"Nearly half the nation's physicians face total cuts next year of 6 percent to 20 percent" because of the combined effects of the various factors, he said.

Administration officials have consistently said they expect physician reporting on the quality of their care to be a part of any action to erase cuts.

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