CMS may target 'inefficient' doctors

Adding yet another wrinkle to the agency's complex relationship with doctors, CMS may begin profiling physicians and targeting those it deems inefficient sometime next year. Herbert Kuhn, acting deputy administrator of CMS, told a House subcommittee that the agency will have the data and computer capacity available to do the tracking as soon as mid-2008. To monitor efficiency, CMS would compare levels of tests physicians order for certain types of patients to tests ordered by other doctors who achieve similar outcomes. The agency would then contact the physicians whose testing patterns seem to be out of line. Kuhn told the subcommittee that his largest concern was figuring out how to use the data to help physicians grow more efficient. To date, the agency hasn't established plans to link efficiency measures with reimbursement changes. If it wants to do so, Congress would probably have to enact new legislation, policymakers said.

To learn more about this initiative:
- read this Kaiser Daily Health Policy Report piece [1]

Related Articles:
GAO: 10 percent of PCPs provide extra services. Report [2]
Physician practice efficiency models examined. Report [3]