How has patient care evolved over the years? 6 key points

Practice Management

A 2015 survey found although patient care is more comprehensive in the current Physician Quality Reporting System, it falls short in some areas, according to a New York City-based Weill Cornell Medicine study.

Under the Medicare Access and CHIP Reauthorization Act, physicians can participate in Merit-Based Incentive Payment System or alternative payment models. Physicians participating in MIPS can receive bonuses and penalties up to 4 percent in 2019. This number will increase to 5 percent in 2020, 7 percent in 2021 and 9 percent in 2022.


Under MIPS, CMS aligns meaningful use of electronic health records, the Physician Quality Reporting System and the Value-Based Payment Modifier.


Journal of General Internal Medicine published the study in its May 19 issue. In the study, researches analyzed 2011 and 2015 surveys, which included 198 and 254 individual measures, respectively, to decipher which quality measures the surveys emphasized and how the two surveys varied.  


Here are six points:


1. The 2015 survey used more outcomes measures including how a patient performs on a particular blood test to assess their diabetes control. The survey especially used more outcome measures during surgery.


2. Both surveys measured different medical specialties, with more than half of the specialties applying to non-internal medicine.


3. The 2015 survey expanded the 2011 reporting categories to include in-demand specialties including surgery, pediatrics, obstetrics and gynecology.


4. The 2015 survey also had focused more on chronic conditions like inflammatory bowel disease, rheumatoid arthritis and dementia.


5. Researchers noted these new measures allow CMS to use a more effective benchmark when elating physician performances in delivering care. However, researchers said the 2011 and 2015 surveys both fell short in measuring how responsive healthcare is in meeting patients' need and value.


6. The surveys do not sufficiently assess patient care's efficiency and its relation to population health, the researchers found.


"We hope that this study will spur interest in looking more closely at PQRS measures, and perhaps even the development of new and improved ones," the researchers concluded. "The next steps would be to understand whether increasing the number and scope of measures would have important effects on physicians and patients."


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