Physicians should look for their confidential Medicare feedback reports next month. They will detail how the cost and quality of care physicians provided to their Medicare patients last year compares to that of other physicians. This is the first time the data will be used to adjust Medicare payments made to some physicians.
The reports, based on care provided in 2013, are scheduled to be made available through the Centers for Medicare & Medicaid Services’ (CMS) Enterprise Portal beginning in September.
In addition to the comparison data, physicians in large groups of 100 or more practitioners will learn whether their Medicare payments next year will be affected by the new Value Based Modifier (VBM), which will bring bonuses to some physicians and financial penalties to others. Smaller practices will get a preview of how they may fare as the VBM is phased in over the next three years.
CMS is required by law to apply the VBM to some physicians in 2015 and to all physicians in 2017. The agency has chosen to apply the modifier to groups of 100 or more practitioners in 2015, groups of 10 or more practitioners in 2016, and all medical groups and solo physicians in 2017.
Adjustments will be based on cost and quality data from two years earlier. That means the forthcoming data, known as “Quality and Resource Use Reports” (QRUR), will determine payment adjustments next year for the groups of 100 or more physicians and other practitioners. The reports will identify which groups will receive positive adjustments, which will see no change and which will be subject to payment cuts of up to 1 percent.
Because the underlying policies that determine the VBM are changing each year, the 2013 reports are not a perfect indicator of the likely impact of the VBM on physicians who will be subject to payment adjustments of up to 2 percent in 2016 and a proposed 4 percent maximum penalty in 2017. But they will offer some guidance about potential VBM adjustments in the future.
For physicians in group practices, data is provided at the group level with drill-downs for individual physicians’ quality data. CMS first began providing QRURs to limited numbers of physicians in 2011 and has expanded report availability over time. Reports using 2012 data already are available for groups of 25 or more practitioners.
The process for gaining access to the reports is complicated and requires a user ID and password for the “Individuals Authorized Access to the CMS Computer Services” site, which must be renewed periodically. In preparation for the release of the 2013 reports, physicians should make sure their group has an up-to-date password.
Additional information about the reports and the VBM is available on CMS’ website.
