Endocrine Insider
February 21, 2007

Although many questions remain about the implementation of the quality measures reporting program, many in the field are encouraging physicians to participate when the program begins in July 2007. Not only will this allow physicians to be paid for something that they will likely be mandated to do in the future, it also allows physicians to smooth out the process in their own practices for reporting measures.

A question weighing on the minds of physicians is how much they can expect to receive for reporting quality metrics. The medical director for quality improvement of the American Academy of Family Physicians developed a back-of-the-envelope calculation to help physicians determine how much they could expect to receive by reporting quality measures under the new CMS program. An average, full-time, family physician bills about $500,000 annually, 22 percent of which is billed to Medicare (approximately $55,000 in Medicare charges during a 6 month period), which would result in a 1.5 percent bonus of $825 for 6 months (Part B News, January 8, 2007). Other specialties may have a higher percentage of Medicare patients, but this formula could provide a ballpark figure of how much a physician could expect to receive for reporting quality measures from July to December 2007.

While reporting quality measures this year may not provide a significant financial boost to a practice, there could be benefits that outweigh the costs. For instance, Dr. Michael O’Dell, who heads a 27-physician family practice in Tupelo, Mississippi, found that patient care has improved as a result of tracking diabetes quality measures. Tracking foot exams for his 1,200 patients with diabetes has prevented amputations, and tracking Hemoglobin A1c and LDL cholesterol, both PVRP measures for diabetics, have resulted in global improvements (Part B News, January 8, 2007). He has also been able to develop tracking mechanisms to collect patient data before or during the visit, as well as phase in quality measure tracking into his electronic medical record.

Endocrine Society staff will continue to monitor CMS’ progress toward implementation of the quality reporting system, and will report on future developments in Endocrine Insider.