Does the legislation expand the role of government into the practice of medicine with respect to implementing payment changes, determining quality and dictating standards of care?
Physicians will continue to exercise considerable control over the practice of medicine and the care that they provide to their patients. Nonetheless, several provisions in the legislation remain troubling, such as value index adjustments to individual physician payments based on cost and quality outcomes, potential penalties on physicians who do not successfully participate in the Physician Quality Reporting Initiative (PQRI), and public reporting of physician claims data to develop performance reports. The legislation contains some safeguards related to these provisions and the AMA will work aggressively for additional safeguards in subsequent correction bills. PQRI penalties for physicians that do not meet reporting criteria, and the value index adjustments to individual physician payment are not scheduled to be implemented until 2015. The legislation also calls for improving payment accuracy by identifying and addressing misvaluations within the Medicare physician payment schedule.
