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February 2007 Pamela Johnson The Tax Relief and Health Care Act of 2006, H.R. 6111, provides a 1.5-percent bonus payment for physicians who report pay-for-performance measures in 2007 to the CMS. Congress has appropriated $300 million for the bonus payments, but the details of the CMS Physician Voluntary Reporting Program still need to be worked out and many unanswered questions remain. Additionally, Congress altered the timeline for approved performance measures for 2007, stipulating in H.R. 6111 that any performance measures would have to be approved by the CMS by Jan. 31 to be included in the voluntary program’s list of approved measures. Participation is specialty-specific, and the current list of 66 program measures does not include any specific to pathology. The American Medical Association (AMA) has designated the College the lead organization to develop pathology measures. Initial performance measures based on breast and colon/rectum cancer protocols and developed by a CAP working group have been approved by the CAP Board of Governors and submitted to the AMA’s Physician Consortium Pathology Working Group for further refinement. Once endorsed by the National Quality Forum or Ambulatory Care Quality Alliance, the measures will then be sent to the CMS for implementation in 2008. The CAP considered whether to seek the alliance’s approval of its two Board-approved pay-for-performance measures on breast and colon cancer. It decided not to pursue endorsement to meet the Jan. 31 deadline, reasoning that the risks outweighed the benefits of prematurely rushing through measures that may be used inappropriately for a small and uncertain bonus payment that may not serve the interests of pathologists. Pamela Johnson is CAP assistant director for economic affairs, and Janemarie Mulvey is CAP director for economic affairs, Washington, DC. |
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