CMS Official Says Medicare May Be Capable of Profiling Doctors In 2008

According to a May 11, 2007 CQ Healthbeat report, "The Medicare program has the data and the computer capacity to identify individual doctors who are inefficient compared with their peers and may begin contacting them as soon as mid-2008 to goad them to become more efficient, a top federal official testified Thursday" (5/10/07) at a House Ways and Means hearing.

CMS' acting deputy administrator, Herbert Kuhn, said, "It's an ambitious goal, but I think we need to set ambitious goals if we're moving forward in this important reform area." The hearing focused on finding "new ways to control the growth in the volume of office visits, tests and procedures that doctors order for Medicare beneficiaries. There's widespread agreement that the current method for doing that -- cutting payments if volume exceeds a yearly spending target -- isn't working."

Profiling supporters "say doctors often become more efficient when presented with comparative data on their care giving, since it encourages them to conform to the ways in which their more efficient peers treat patients." CQ notes, "Witnesses at the hearing also expressed support for other methods of controlling volume growth, including paying for 'bundles' of services rather than individual services, improving the accuracy of payments, and paying doctors to coordinate the care of chronically ill patients." Medicare Payment Advisory Commission chairman Glenn Hackbarth "faulted 'large errors' in Medicare payment accuracy for fueling some volume growth. For example, Medicare payments for imaging may be too high because they do not account for lower costs that come with high usage rates for imaging devices, he said."