Home From The Editor Taking full advantage when the stakes are low

Taking full advantage when the stakes are low

July 2008

Published in the July 2008 issue of Today’s Hospitalist

WITH MEDICARE ESCALATING its efforts to bring pay for performance to the inpatient setting, it’s a good time for you to take a moment to ask not only what you need to do to protect your own pay, but that of the hospital where you work.

A good example of how Medicare is turning its attention to individual physicians in the hospital environment is the Physician Quality Reporting Initiative (PQRI). The program, which rewards physicians for reporting patient data on a relatively small scale, began in July of last year and is in the middle of its first full year.

While it might not seem important to get involved in a program that’s still in its infancy, nothing could be further from the truth. As this month’s Analysis notes, the program may well expand not only the number of reporting measures that apply to hospitalists, but the amount of the bonus that Medicare pays physicians.

The PQRI program is one small part of a larger effort by Medicare to revamp how it pays for patient care. Later this year, the Centers for Medicare and Medicaid Services (CMS) is initiating its “no-pay” program and will no longer pay the treatment costs for conditions the CMS deems are preventable complications. The CMS is also in the planning stages of its value-based purchasing initiative, which would pay hospitals for their performance on clinical and satisfaction measures.

These proposals “and others like them “are challenging, to be sure. The good news is that they give hospitalists an excellent opportunity to not only boost their own pay, but to establish themselves as a critical resource for hospitals that need help meeting quality and performance measures.

As our coverage of the PQRI program notes, the key to success is getting started early. If you’re going to fail at any of these initiatives, you should fail when the stakes are low. For hospitalists, that time is now.

edoyleEdward Doyle
Editor and Publisher