Dr. D Day, It's Coming...
CMS' Physician Feedback/Value-Based Payment Modifier goes into effect soon. How will it affect doctors and patients?
San Clemente, CA (I-Newswire) September 18, 2013 - Most Americans are familiar with Obamacare or the Affordable Care Act (ACA). Not as many Americans are familiar with the Physician Feedback/Value-Based Payment Modifier. What is it? Medicare's website describes: The Value-Based Payment Modifier (VM) as Medicare's effort to improve the quality and efficiency of medical care at the physician level. It's achieved by providing meaningful and actionable information to physicians so they can improve the care they furnish, and by moving toward physician reimbursement that rewards value rather than volume.
In layman's terms, it means that doctors are now going to be rated on performance (clinical care, patient experience, etc.) & cost. Those ratings will determine the eventual compensation metrics for physicians. The system is, eventually, intended to compensate or penalize doctors for their competitive worth as compared to their peers. I say eventually because the full-fledged VM system is not scheduled to go into effect until CY 2017. In 2015, physician groups of 25+ & 100+ members under the same Tax Identification Number will be the "beta" groups and receive the first round of official ratings from CMS. In 2013, these same large groups received their preliminary Quality & Resource Use Reports (QRUR) which allows them the first look at how their physicians rate in comparison to similar groups.
To figure out how we got to this point, let's look back to where it began. In the beginning, physicians could charge patients whatever their respective market would bear. Insurance companies paid them whatever they asked and no one questioned the system. Then came Medicare and the dynamic began to evolve. Over time Medicare began to restrict reimbursements based upon increasing oversight and regulation of the healthcare industry and physicians which eventually led to 2013 and the launch of Obamacare. In the new affordable care/value based era; procedures, capital equipment and yes; even doctors are being scrutinized more than ever.
As it stands currently (and as we move toward "Dr" D Day 1-1-2017), the reimbursement ramifications to doctors is negligible (0 to -2%) depending on the initial comp scores. But make no mistake; "Dr" D Day will only be the beginning. As the QRUR scores continue to be tabulated and compared, doctors will face the same scrutiny that a professional athlete (results) or CEO (cost containment vs. revenues) would in terms of compensation. For those physicians that do their jobs well in every facet of the process, they have little to fear. However, for those physicians that never concern themselves with cost containment or true patient diagnoses & outcomes, it's coming...
About Bang Surgical
Bang Surgical develops operating room compliant, portable teleconferencing systems. For more information on Bang Surgical, visit www.bangsurgical.com
Media Contact: Rich Roberge
206-441-3778 / Cell: 206-455-4116
About Bang Surgical
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Tags:CMS Medicare Obamacare ACA Affordable Care Act Value-Based Physician Payment Modifier Quality & Resource Use Reports QRUR
Published On:September 18, 2013
Print Release:Print Release
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