Monday Musings

In case you missed it, on January 27th the Obama administration announced its ambitious goal to overhaul the way doctors are paid, tying their fees more closely to the quality of care rather than the quantity. Health and Human Services (HHS) Secretary Sylvia Mathews Burwell made the announcement. Rather than pay more money to physicians for every procedure they perform, Medicare will also evaluate whether patients are healthier, “among other measures.” HHS hopes to tie 30% of traditional Medicare payments to quality or value through “alternative payment models” by the end of 2016. By the end of 2018, HHS hopes to link 50% of payments to some type of quality or value based system. This initiative is already being matched by private insurers, a transition HHS hopes to facilitate through the creation of a new “Health Care Payment Learning and Action Network.”

In case that announcement didn’t completely sink in, you just heard the death knell of fee for service medicine. Volume based payment as we have known it is over. This transition to a new payment system is going to be particularly interesting in the field of wound care. In future postings I will discuss some specific changes on the horizon for wound care. At the very least, in 2015, wound care practitioners had better decide how to participate in the Physician Quality Reporting System (PQRS). Kathleen Schaum has graciously asked me to give a presentation during her post-conference reimbursement session after the Fall SAWC to explain “step by step” the way wound care practitioners can participate in PQRS. Next week I will tell you why this matters.