CMS Physician Voluntary Reporting Program: Weighing the Benefits of Participation

The healthcare industry’s call for quality service is coming from all sides. Health plans, employers, consumers and even the federal government are leaning on healthcare providers to document the quality of the care they provide. The Centers for Medicaid & Medicare Services (CMS) is now asking for even more reporting. Physicians can now voluntarily self-report adherence to certain evidence-based quality measures to CMS. Given the benefit of confidential feedback, physicians are encouraged to open their practices to performance improvement and apply lessons learned on their own terms.

In this special report, "CMS Physician Voluntary Reporting Program: Weighing the Benefits of Participation," based on a recent audio conference, expert speakers explore the role of CMS’ Physician Voluntary Reporting Program (PVRP) in the context of healthcare’s pay-for-performance environment. Highlighting industry trends and directions, they tap into their own experiences to explain how physician groups can use this and other programs to enhance their organization's performance and improve patient outcomes while still preserving the bottom line.

You'll hear from Julie Baker, director, healthcare advisory practice, PricewaterhouseCoopers and Robert Fortini, clinical operations manager, Community Care Physicians on the factors driving quality improvement, strategies for success in pay-for-performance programs and how Community Care Physicians is building quality reporting into its practice for P4P programs, including the voluntary CMS program.

This 45-page report is based on the January 26, 2006 audio conference "CMS' New Voluntary Physician Pay-for-Performance Program: Identifying the Opportunities" during which Baker and Fortini provided an inside look at pay-for-performance programs along with why and how Community Care Physicians is participating in CMS' new program.

You'll get details on:

• Today's P4P environment;
• Highlights of CMS' Physician Voluntary Reporting Program;
• Applying lessons learned from CMS' Hospital Premiere P4P Program;
• The benefits of participation in PVRP;
• How physicians can build a solid P4P program; and
• How Community Care Physicians overcame the obstacles to P4P participation.

Table of Contents

• The Demand for Performance Improvement
  • Introducing Pay for Performance
  • An Industry Trend Takes Hold
  • CMS Program Applies Lessons Learned
  • Defining Quality, Standardizing Measures
  • Identifying the Opportunities
  • Acknowledging the Challenges
  • P4P Becoming a Dominant Industry Force
  • Tapping into the Trend
  • Hospital Providers React to Changing Market Dynamics
  • Selling the Product
  • Moving Toward National Accreditation
  • Making Incentives Matter
  • Getting Ahead: Strategies for Success
• Case Study: Community Care Physicians Presents the Participant Perspective
  • Building a Solid Program
  • Defining Your Own Parameters
  • Effect of Visit Frequency on HgA1C Levels
  • Taking the Next Step
  • A Systematic Approach to Disease Management
  • Targeting High-Risk Populations
  • Overcoming the Obstacles
  • A Commitment to Performance Improvement
  • Coping with Data Collection
  • Finding New Routes to Enhancement
  • A Challenging Endeavor
  • Electronic Medical Records: Friend or Foe?
• Q&A: Ask the Experts
  • Keeping Up with Reports
  • Bridges to Excellence Eligibility
  • Taking and Reporting HgA1C and LDL Levels
  • Clarifying Data Collection
  • Submitting the Data
  • Facilitating Communication
• Glossary
• For More Information
• About the Authors