Get your comments in by the Dec. 29 deadlines.
You'll have only two weeks to digest the details of the coming pay for performance demonstration before giving your feedback on it.
Comments to the Centers for Medicare & Medicaid Services and P4P demo contractor Abt Associates are due Friday Dec. 29, but CMS and Abt didn't hold the special Open Door Forum on the demo until Wednesday Dec. 13 (see Eli's HCW, Vol. XV, No. 43). However, they did release the following details in advance of the forum. Who: Participation in the demo will be voluntary and will consist of a control and experimental group, an Abt slide presentation on CMS' P4P Web site explains. What: The P4P demonstration project will reward both agencies that have high outcomes scores and those that improve the most. Details on how CMS proposes to identify the best performers and improvers are in the slide presentation at
www.cms.hhs.gov/DemoProjectsEvalRpts/downloads/HHPP_Presentation.pdf. The bottom line is that agencies will have to hit certain thresholds to qualify for extra payment. No agencies will lose payment by participating in the demo, CMS assures. But the incentive payments will be drawn from a reduction to all HHAs' payments overall. Where: CMS is still deciding whether to limit the demo to a few states or allow national participation. When: Abt and CMS aim to finish the demo's design by early 2007, recruit participants in spring and summer and run the project from October 2007 through September 2009. Because the formula to figure incentive payments depends on claims data, agencies actually won't know how much money they'll receive until after the year has concluded and claims are processed. Why: Besides the straightforward goal of offering more payment for higher-quality or improved care, the demo also aims to determine whether "a performance-based system can improve the quality of care of Medicare beneficiaries while not increasing Medicare expenditures," Abt notes. The demo will be highly influential in determining the final structure of industry-wide P4P that CMS promises is coming soon, experts predict. How: CMS and Abt propose to base the measurements on these eight Outcome-Based Quality Improvement measures: • Incidence of Acute Care Hospitalization
• Incidence of Any Emergent Care
• Improvement in Bathing
• Improvement in Ambulation/Locomotion
• Improvement in Transferring
• Improvement in Urinary Incontinence
• Improvement in Management of Oral Medications
• Improvement in Status of Surgical Wounds. v Note: Comments are due to CMS by Dec. 29 at
HHP4P@cms.hhs.gov.
