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Pay for Performance Initiatives

The Medicare program and many private insurers are looking to ensure that the services they pay for are of high quality. As a result, the Centers for Medicare and Medicaid Services has developed quality reporting programs in several settings including nursing homes, home health, hospitals and outpatient facilities. These programs are voluntary and have financial rewards for participation. The following resources help explain the various pay for performance initiatives.


CMS Roadmap for Quality Measurement (.pdf) - 1/21/09
CMS Roadmap for Value-Based Purchasing (.pdf) - 1/21/09
CMS Quality Initiatives Resource Center - 10/31/08
Home Health Quality Initiatives (.pdf) - 10/31/08 Restricted
Hospital Aquired Conditions & Present on Admission Indicators (.pdf) - 10/31/08 Restricted
Overview of Medicare's Quality Initiatives (.pdf) - 10/31/08 Restricted
Post Acute Care Payment Reform (.pdf) - 10/31/08 Restricted
Quality Improvement Organizations (.pdf) - 10/31/08 Restricted

Quality Reporting Program

PQRI establishes a financial incentive for eligible professionals, including physical therapists, to participate in a voluntary quality reporting program. PTs who successfully report on at least three quality measures on claims for dates of service from January 1 to December 31, 2010, may earn a bonus payment of 2% of total allowed charges for covered Medicare Physician Fee Schedule services. Many of the 2010 resources have not been issued at this point. When they become available, we will post them on our Web site.

Click here to access our PQRI resources.


 
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