The
Congressional Budget Office (CBO) on Dec. 17 released two
new reports examining issues within the U.S. health care system.
The first report, “Key Issues in Analyzing Major Health
Insurance Proposals,” examines background information,
as well as large-scale reform proposals. The report finds
that the rising costs of health care and health insurance
will be a significant problem to the country’s financial
stability. Meanwhile, the number of nonelderly residents without
health insurance is likely to increase substantially, from
at least 45 million in 2009 to about 54 million in 2019. According
to the report, the “problems cannot be solved without
making major changes in the financing or provision of health
insurance and health care.”
The second
report, “Budget Options, Volume 1: Health Care,”
discusses the projected effects of 115 discrete options for
the financing and delivery of health care. The options range
in topic and include: the private health insurance market;
tax treatment of insurance; quality and efficiency of health
care; health behavior and health promotion, among others.
The report provides cost or savings estimates on a year-by-year
basis for five years and a 10-year total. ACC staff is currently
reviewing the reports. The College applauds CBO's efforts
to address these critical issues related to health care reform.
For more information, visit: http://qualityfirst.acc.org.
E-Prescribing
Program Begins
Under
new federal law, beginning on Jan. 1, 2009, physicians who
successfully e-prescribe will be eligible to participate in
a new incentive program. Physicians who successfully e-prescribe
under the program requirements will receive incentive payments
of 2 percent in 2009. The size of the payment will decrease
to 1 percent in 2011 – 2012 and 0.5 percent in 2013.
Those who have not adopted e-prescribing by 2012 will be penalized
by 1 percent of Medicare-allowed charges, with the penalties
size growing in 2013 and beyond. CMS has released the technical
specifications for e-prescribing systems that must be
present to qualify for the program.
The ACC
highly encourages members to adopt e-prescribing, and offers
tools and resources to members to assist in the adoption and
use of health information technology, including a “how-to”
guide to help clinicians make informed decisions about
how and when to transition from paper to e-prescribing systems.
Visit ACC’s Web site at http://www.acc.org/HealthIT
for more information.
CMS
Releases 2007 PQRI Report
The
Centers for Medicare & Medicaid Services (CMS) released
its 2007 Reporting Experience report on the Physician Quality
Reporting Initiative (PQRI) on Dec. 3, and held a conference
call on Dec. 16 to discuss the report and field questions.
CMS acknowledged in the report that many eligible professionals
had difficulties with various aspects of the 2007 PQRI program
and the reports. Data showed that about 16 percent of eligible
professionals participated in 2007 PQRI, and just over half
submitted valid quality data codes (QDCs) and received a bonus
payment. CMS also acknowledged that 48.4 percent of the QDCs
reported were submitted invalidly.
CMS continues
to review the 2007 data and is reassessing whether some professionals
who did not receive a bonus payment during the 2007 period
may actually qualify for payment. However, this may impact
physician payments for the 2008 PQRI reporting period, with
eligible professionals receiving payments and feedback reports
as late as October 2009. The agency also is addressing questions
and problems related to the feedback reports, and may make
changes to improve the program, feedback reports, and the
quality of CMS education and outreach related to PQRI. The
College is engaged with CMS to resolve issues related to the
2007 reporting period, as well as the finalization of 2008
reporting and preparations for the 2009 program. To view the
report, click
here.
CMS
Releases 2009 PQRI Technical Specifications
The
Centers for Medicare & Medicaid Services (CMS) has released
the 2009 technical specifications for the Physician Quality
Reporting Initiative (PQRI). As part of these specifications,
CMS has included a new measure for cardiology, measure #152:
CAD: Lipid Profile in Patients with CAD. In addition, CMS
has determined that some of the PQRI measures used during
2008 are not conducive to claims-based reporting and, in 2009,
will only be accepted via registry-based reporting. The measure
that impacts cardiology is measure #7: “CAD: Beta-Blocker
Therapy for CAD patients with Prior Myocardial Infarction.”
Practices should plan to discontinue submitting this measure
via their claims process effective Jan. 1, 2009. For a list
of 2009 measures and reporting options per measure, click
here. The ACC will update its PQRI toolkit in early January.
Please check for updates.
ACC
Comments on Proposed Imaging Efficiency Measures
The
ACC has submitted comment letters to the Centers for Medicare
& Medicaid Services regarding a set of imaging efficiency
measures for outpatient hospital imaging centers that were
developed by The Lewin Group, National Imaging Associates,
and Dobson & DaVanzo. Two of the proposed measures would
impact cardiovascular imaging: inappropriate stress imaging
prior to low-risk surgery and inappropriate stress imaging
within five years of CABG. The submitted comments reflect
concerns around the potential inclusion of patients with chest
pain or the equivalent being captured by these measures, which
would change the testing from inappropriate to appropriate.
The ACC also emphasized the need to validate these measures
through testing prior to using for public reporting or measurement.
The two comment letters can be found on the Imaging
Services & Referral Resource Center.
QUALITY
Health
IT Funding Must Encourage Interoperability, Leavitt Says
In
an opinion piece in the Washington Post on Monday,
Department of Health and Human Services Secretary Mike Leavitt
wrote that including health information technology (IT) funds
in an economic stimulus package “could spur a critical
mass of the nation’s doctors to finally enter the information
age.” However, “unless the funds are tied to standards
for the interoperability of health IT systems, the expenditure
could do more harm than good,” he continues. This is
because if “stimulus money supports a proliferation
of systems that can’t exchange information, we will
only be replacing paper-based silos of medical information
with more expensive, computer-based silos that are barely
more useful” because information will be “trapped
in proprietary systems, unable to get where it’s needed,”
Leavitt writes. Leavitt’s opinion piece is available
in full online.
Hospital
Spending on CV Disease Nearly $60B, Study Finds
Spending
on cardiovascular disease by U.S. hospitals increased to $57.9
billion in 2006, up 40 percent from 1997, according to the
latest News and Numbers report from the Agency for Healthcare
Research and Quality (AHRQ). According to the report, which
is based on data in HCUP Facts and Figures, 2006, the majority
of the growth occurred between 1997 and 2003, at which point,
annual growth dropped to less than 2 percent. This slowing
is a result of a decrease in the number of heart disease patients
and slower growth in cost per patient, the report suggests.
In addition, the report found that cardiovascular disease
accounted for 17.6 percent of the $329 billion of total hospital
spending on patient care in 2006, a decrease from the 18.7
percent of $216 billion spent by hospitals in 1997. More information
is available about the study online.
