Physician quality reporting means greater financial risk for hospitals

As hospitals acquire more and more physician practices, it can mean increased costs, due in part to pending payment adjustments to the Physician Quality Reporting System (PQRS). To avoid penalties, hospital leaders must move beyond a hospital-centric perspective, according to Healthcare Finance News.

PQRS incentive payment adjustments begin this year, and it will impact many hospitals and health systems that participated in the recent wave of practice acquisitions. However, many of those providers have maintained such a hospital-focused routine that they aren't prepared for compliance with physician-specific measures, Larry Magras, senior director at Huron Healthcare in Chicago, told the publication.

To target physician quality, he said, hospitals must incorporate inpatient and outpatient metrics into their quality committees, and chief quality officers must create interdisciplinary teams, with every site of care represented. "Quality committees have been focused on nursing staff and not on physicians," Magras told Healthcare Finance News. "That focus needs to shift to the outpatient environment."

At stake under PQRS is a 1 percent penalty for noncompliance, set to double in 2017. Potential penalties will increase further in coming years, reaching 9 percent by 2022, which could be a major loss for practices with large numbers of Medicare patients, Dorrie Guest, director of Deloitte Consulting, told Healthcare Finance News, especially in combination with the shift to value-based models.

To avoid this outcome, the article suggests hospital executives identify the incentives that will lead to better outcomes and talk to physicians about hot-button issues, such as readmissions and co-morbidities.

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