Primary Care Competition and Quality of Care: Empirical Evidence from Medicare's Physician Quality Reporting System

2018 ◽  
Author(s):  
Christopher Brunt ◽  
Joshua R. Hendrickson ◽  
John R. Bowblis
2020 ◽  
Vol 29 (9) ◽  
pp. 1048-1061
Author(s):  
Christopher S. Brunt ◽  
Joshua R. Hendrickson ◽  
John R. Bowblis

2016 ◽  
Vol 2 (1) ◽  
pp. 5-8
Author(s):  
Benjamin Farahnik ◽  
Mio Nakamura ◽  
Tina Bhutani ◽  
John Koo

The Department of Health and Human Services has announced a campaign for transitioning Medicare reimbursement from volume to value. A budget-neutral Value-Based Payment Modifier has been implemented that provides for differential payment to physicians based upon the quality of care delivered. The value modifier will be based partially on physician participation in the Physician Quality Reporting System (PQRS), which allows for reporting of information on quality of care to Medicare. The information reported includes both medical data and patient-reported experiences with health care providers. Starting in 2017, the value modifier payment adjustment will apply to all physicians who make Medicare part B fee-for-service charge claims. Physicians who do not participate in the PQRS and satisfy reporting requirements may be assessed negative adjustments to their payments. Dermatologists in particular will be impacted by these changes, as skin diseases, especially psoriasis, account for a significant economic burden in the U.S.


2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 286-286
Author(s):  
Erica J. McNamara ◽  
Andrew Stewart ◽  
E. Greer Gay ◽  
James Banasiak ◽  
Bryan E. Palis ◽  
...  

286 Background: The Rapid Quality Reporting System (RQRS), developed by The Commission on Cancer of The American College of Surgeons, allows accredited cancer programs to prospectively monitor adherence to five National Quality Forum endorsed quality of care metrics for breast (BC) and colon (CC) cancer. This study assesses differences in performance rates by patient populations and demonstrates the impact a prospective clinical performance tracking system can have in impacting care. Methods: RQRS tracks and measures compliance with the following measures: Radiation therapy within one year of diagnosis (dx) for women <70 receiving breast conserving surgery for BC (BCS/RT); hormone therapy within one year of dx for AJCC T1c, N0M0, or stage II or II; hormone receptor positive BC (HT); multi-agent chemotherapy within four months of dx; age < 70; hormone receptor negative BC (MAC); adjuvant chemotherapy within four months of dx; age <80; AJCC stage III CC (ACT); pathologic examination of ≥12 regional lymph nodes for surgically resected CC (12RLN). 64,129 RQRS measure eligible cases diagnosed from 2006 to 2010 from 64 RQRS beta test centers were assessed. Performances rates, before and after implementing the RQRS beta test, were compared by patient demographics. Results: Between 2006 to 2010, compliance rates increased significantly for all five measures, ranging from a 16% increase for MAC to 36% for HT. Prior to RQRS participation, BCS/RT, HT and ACT compliance was significantly lower in patients of other races cf. to white and black; for MAC, other races were lower cf. to white. By 2010 a difference by race remained only in BCS/RT. Payer status and age also impact care. Private insurance cases were more likely to receive compliant care for BCS/RT, MAC and 12RLN; with Medicare for HT (p<.05). Age impacted HT (<40 less likely) and ACT (70-79 less likely cf. to 40-49) (p<.05). Conclusions: Increased performance rates show a system which promotes the ability to track patients in real clinical time can improve quality of care. By using RQRS to prospectively monitor expected adjuvant care, programs can proactively intervene and address potential issues that could impede delivery of timely standard of care.


2013 ◽  
Vol 65 (2) ◽  
pp. 235-243 ◽  
Author(s):  
Jeffrey R. Curtis ◽  
Pradeep Sharma ◽  
Tarun Arora ◽  
Aseem Bharat ◽  
Itara Barnes ◽  
...  

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