A Medical Device Daily

Michael Maves, MD, president of the American Medical Association (Chicago), has sent a memo to the heads of state medical associations and physician specialty societies addressing an agreement reached by AMA officials with U.S. lawmakers to develop a set of quality measures for physician care (Medical Device Daily, Feb. 23, 2006).

Maves says in the memo that the agreement is feasible and that AMA did not agree to a pay-for-performance system without receiving assurances that doctors would receive sufficient reimbursements to treat Medicare patients.

Late last year, the AMA reached an agreement with congressional leaders to develop about 140 standard measures of performance for physicians covering 34 clinical areas by the end of 2006. The performance measures, the AMA said, are intended to provide information on the treatment of patients using best practices.

According to the agreement, beginning in 2007 doctors will report to the federal government on “three to five quality measures per physician.” And it said that the doctors “should receive” some additional payments to reflect the costs of data collection and reporting. “By the end of 2007, physician groups will have developed performance measures to cover a majority of Medicare spending for physician services,” according to the agreement.

The agreement was signed by AMA Chair Duane Cady, Sen. Chuck Grassley (R-Iowa), and Reps. Nathan Deal (R-Georgia) and Bill Thomas (R-California).

Seven medical specialty groups have responded by sending a letter to Cady saying that it would be “difficult if not impossible” to achieve that goal of 140 measures by the end of the year. The letter also said that the AMA did not consult with other physician groups before signing the agreement.

In his memo, Maves says the 140 measures are doable since 90 measures already have been developed by the AMA-led Consortium for Physician Quality Improvement ; additionally, 10 new clinical topics currently are being developed. According to Maves, “By demonstrating progress on quality reporting, we will be in a better position to secure congressional action on the Medicare physician pay cuts slated to begin in 2007.”

He also noted that no pay-for-performance system can be put in place until Congress enacts the necessary enabling legislation.

Hospitalization for complications on rise

The number of patients admitted by U.S. hospitals to treat complications resulting from surgery or medical treatment increased from 305,000 in 1993 to 452,000 in 2003, according to data released by the Agency for Healthcare Research and Quality (AHRQ; Washington), a unit of the Department of Health and Human Services.

Complications from surgery can include postoperative infections. Complications from medical care can result from extended bed rest and may include lung embolism, dangerously low blood pressure, or collapsed lung.

The number of cases of surgical or medical care complications admitted through hospital emergency departments rose from 98,000 in 1993 (32% of all cases) to 211,000 (47% of all cases) in 2003. The average cost to hospitals for treating surgical or medical complications increased from $6,840 in 1993 to $9,600 in 2003.

The statistics come from the Nationwide Inpatient Sample, part of AHRQ’s Healthcare Cost and Utilization Project. This project comprises a family of databases and related software tools developed through a federal/ state/industry partnership and sponsored by AHRQ. HCUP includes the largest set of publicly available databases on all patients in the U.S., regardless of type of insurance or whether the patients had insurance.

Hagel forms healthcare commission

Sen. Chuck Hagel (R-Nebraska) has formed a commission of healthcare experts to develop healthcare reform recommendations for federal legislation, according to a report by the Omaha World-Herald.

The commission is made up of 10 members who will examine healthcare access and quality, cost control, the roles of medical science and technology to improve care, and the effect that baby boomers will have on future costs, according to the newspaper. Part of the commission’s mandate is identifying “more effective financing vehicles for American healthcare than current public and private plans.”

Hagel said that the goal would be to ensure sustainable healthcare for all families. Chuck Marr, founding CEO of Alegent Health (Omaha), will serve as chair of the commission.

“Having accessible, affordable and quality healthcare is the desire of every American,” Marr said.

Hagel said, “As medical technologies advance and our population ages, healthcare will become increasingly important to maintaining America’s competitive position in the world.” He asked the committee to submit its recommendations after one year of study.

Bill tackles women’s heart disease, stroke

A group of women lawmakers, described as bipartisan in makeup, has introduced a bill (S. 2278) that would require health information currently reported to the federal government to specify gender to improve efforts to prevent heart disease and stroke among women, according to a report by CQ HealthBeat.

The HEART for Women Act would call for annual recommendations to Congress on efforts to improve the treatment of heart disease and eliminate disparities in care. In addition, the legislation would make available in all 50 states for a program by the Centers for Disease Control and Prevention (Atlanta) that provides heart disease and stroke tests to low-income, uninsured women at no cost. The program currently is available in 14 states.

Sen. Debbie Stabenow (D-Michigan), co-sponsor of the bill, said, “We all have to stop thinking of heart disease as a ‘man’s disease’ and start insisting on improvements in the prevention, diagnosis and treatment of heart disease among women.”

Supporters of the legislation include the American Heart Association, the American Stroke Association, the National Coalition for Women with Heart Disease and the Association of Black Cardiologists.

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