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Senate Finance Committee Recommends Ways that Medicare Can Enhance Current Physician Quality Reporting Initiative (PQRI)

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Highlights the Role of Certifying Boards in Quality Measurement & Improvement

Philadelphia, PA, January 25, 2008 – Recognizing that PQRI – Medicare’s new program for rewarding physicians based on performance – needs to be improved, the Senate Finance Committee has issued recommendations to the Center for Medicare and Medicaid Services (CMS) to include alternatives for measuring and reporting performance, including “registry-based” methods that are a part of the specialty certifying boards' voluntary assessment programs. If implemented correctly, these alternative approaches would reduce reporting redundancy and accelerate physician quality improvement efforts, according to the American Board of Internal Medicine (ABIM).

The recommendations were included in a letter from Senators Baucus and Grassley to CMS and were in response to the recent Medicare legislation [MMSEA, section 101(b)(2)(B)] authorizing the Department of Health and Human Services to enhance the PQRI program by aligning federal efforts with those of other quality leaders, including certifying boards, specialty societies, NQF and NCQA.

“The Senate Finance Committee’s recommendations could help sharpen the government’s approach to improving quality while, through alignment, reduce the time and systems needed for physicians to meet the myriad reporting requirements they face from health plans, hospitals and the government,” said Christine K. Cassel, MD, President and CEO of the American Board of Internal Medicine. “This would leave more time for physicians to do what they do best – deliver care to America’s patients.”

In their recommendations to CMS, Senators Baucus and Grassley highlight certifying board’s expertise in quality measurement and argue that, “Physicians should be recognized and rewarded for registry-based reporting of performance data that combines information regarding Medicare, Medicaid, and other patients.” They emphasize that many specialty-certifying boards' programs could qualify as these registries.

“Including Maintenance of Certification as part of physician quality reporting in Medicare would effectively align professional, payer and public sector measures – providing physicians who chose to pursue this pathway with a more efficient approach to measuring and improving their performance,“ added Cassel.

At the individual physician’s request, health plans and hospitals have already begun to use ABIM’s Maintenance of Certification programs as markers of physician quality and include such programs in their reward/recognition efforts.

The American Board of Internal Medicine requires physicians who were board certified after 1990 to maintain their certification every 10 years. The Maintenance of Certification program is based on guidelines established by the American Board of Medical Specialties and includes four components – verification of credentials, a knowledge exam in a physician’s specialty area that assesses diagnostic acumen and clinical judgment, knowledge modules that pose a series of questions for physicians to demonstrate they are keeping up with the latest developments in the field, and a self-evaluation of practice performance through data collection, reporting and assessment.

ABIM Board Certified Doctors Make a Difference
Internists and subspecialists who earn and maintain board certification from the American Board of Internal Medicine (ABIM) differentiate themselves every day through their specialized knowledge and commitment to continual learning in service of their patients. Established as an independent nonprofit more than 80 years ago, ABIM continues to be driven by doctors who want to achieve higher standards for better care in a rapidly changing world. Visit ABIM's blog to learn more and follow ABIM on Facebook and Twitter. ABIM is a member of the American Board of Medical Specialties.