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CMS Proposes Measures to
Rate-and Pay-Doctors, Assess Satisfaction of Patients with Hospital Care
The Commonwealth Fund
November 16, 2004
The Centers for Medicare and Medicaid Services announced Tuesday that it
is moving ahead with a set of measures to assess the quality of care
provided by doctors outside the hospital and to pay them based on those
ratings. The agency already rates hospitals, nursing homes, home health
agencies, and dialysis facilities on care and posts that information
publicly to help patients pick a facility and to goad providers themselves
into making improvements.
The new effort to assess the quality of care doctors provide in their
offices consists of a set of "ambulatory care" measures
developed with the American Medical Association and the National Committee
for Quality Assurance, CMS said. "By collecting this information, we
will be able to use these ambulatory measures to pay providers for
improving the quality of care," said CMS Administrator Mark
McClellan.
"The goal is to measure the improvement of care for such clinical
conditions as coronary artery disease and heart failure, diabetes, high
blood pressure, osteoarthritis, asthma, behavioral health, prenatal care
and preventive care," the agency explained.
CMS is submitting the measures to the National Quality Forum, an
organization that develops consensus between government and provider
organizations on what measures should be used to rate quality. "The
measures will be used to pay physicians to monitor, report on and improve
the care provided to Medicare beneficiaries," the agency said. It
added that it expects to actually use the measures in pilot projects in
2005.
CMS also is moving ahead with a set of "patient satisfaction"
measures that complement existing measures that assess the extent to which
hospitals perform certain clinical procedures known to improve quality.
The added "HCAHPS" measures, developed by the Agency for
Healthcare Research and Quality, assess care from the perspective of the
patient.
Patients rate how well doctors and nurses at the hospital communicate with
them. They also rate the responsiveness of staff, the cleanliness and
quiet of the hospital environment, how effectively the hospital controls
pain, how well it communicates about medicines and the discharge
information it provides, as well as giving an overall rating of the
facility.
CMS is also submitting these measures to the National Quality Forum. It
says hospitals will begin collecting the patient satisfaction data in
2005, and plans to post the information publicly to help patients pick a
hospital.
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