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The Center for Medicare and Medicaid Services (CMS) moves slowly but once they start down a path, they don’t stop (no matter who is the President). In 2008 they started down a path to link Physician payment to patient outcome. It doesn’t seem real yet. If you do nothing about reporting, you can lose 9% of your Medicare Part B payment – but you can report metrics that are meaningless to your specialty and avoid the penalty. There’s no incentive to take the program seriously when the “bonus” is less than 2%. Right now the entire exercise seems like 5th grade “busywork.”

The problem for us in wound care and hyperbaric medicine is that CMS will eventually link payment not just to “patient outcome” but to patient cost (meaning, how much your patients cost Medicare per year). And what will we get measured on? Things like blood pressure control, hemoglobin A1C level, and rehospitalization for congestive heart failure. Conditions we don’t manage.

Knowing what’s coming, I’ve spent 13 years banging my head on CMS’ Kafkaesque “quality” system – trying to develop and keep some measures that are relevant to what we do. They aren’t perfect – in part because the whole definition of quality is screwed up, but I don’t make the rules.

For 6 years the US Wound Registry has been narrowly hanging on to quality measures in wound care and hyperbaric medicine which truthfully no one has any incentive to report right now. However, if we don’t have quality measures that are relevant to our practice, in the near future, Medicare will implement a variety of ways to pay us less – potentially a lot less (and so will the private payers).

This year, I need your help – this survey will take 7 minutes. I need at least 20 advanced practitioners to take this survey by Wednesday, August 25 to have a chance of keeping quality measures around in wound care and hyperbaric medicine. Because the light at the end of the tunnel is a train.

Here’s the link: https://forms.office.com/r/p9ya0yR7N5

Caroline


Dr. Fife sees patients at the CHI St. Luke's Hospital Wound Clinic in The Woodlands, Texas. For an appointment call (936) 266-2150.



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