Pay-for-Performance: Legislative Activity

What is the issue?

In 2006, Medicare began its first large scale demonstration of pay-for-performance (P4P) in the Part B program. The initial project included voluntary reporting of a starter set of evidence-based quality measures. Participating physicians received quarterly performance feedback reports.

In December, 2006 Congress passed the Tax Relief and Health Care Act of 2006, which authorized an expansion of this earlier program into a volunatary pay for reporting program. The Physician Quality Reporting Initiative (PQRI) is a voluntary program that will provide a bonus to physicians and other eligible professionals who successfully report quality measures related to services provided under the Medicare Physician Fee Schedule between July 1 and December 31, 2007. Unlike the starter set of measures, the PQRI includes neurology-specific measures on stroke and screening for geriatric falls.

Why is it important?

Though Congress has not mandated the participation of physicians in the Medicare PQRI, it is possible they could in the future. As Medicare expenditures grow and the baby boom population ages in, Congress will be reevaluating how Medicare funds and provides health care.

What is the Academy's position?

As these changes happen, the AAN Professional Association (Academy) is committed to advocating to make sure that future P4P initiatives ensure that:

• The best quality care for the patient remains as the main objective of a P4P program;
• Specialty-specific quality measures are developed by societies like the Academy to ensure that they reflect the best available evidence and the clinical realities for the patients they treat;
• Small and solo-physician practices are given the necessary financial assistance to adopt the health information technology (e.g., electronic health record systems) needed to fully participate in future P4P programs;
• Physician participation is voluntary and fairly compensated;
• Incentives should be given to physicians that improve as well as those providing high quality care; and
• Implementation should be phased-in to allow time for quality measure development and physician preparation.

What can you do to help?

The Academy has developed an advocacy toolkit (to the right) to help you advocate on this important issue.