Federal legislation has mandated that physicians who provide high-quality, low-cost care be rewarded with up to a four percent bonus on their Medicare reimbursement while those who are deemed to provide low quality, high cost care may have up to a four percent withhold of their Medicare reimbursement to pay for the better performing physicians.
This bonus and penalty program is referred to as the Value Based Payment Modifier (VBM). Medicare (CMS) wants you to know how you are doing in the hopes that better performing physicians, as compared to their peers, will keep it up and that those who are not doing so well, will voluntarily improve.
To let you know how you are doing, CMS is making individual and group cost and quality data in the form of the quality and resource use reports (QRUR) available. According to CMS, the QRURs provide comparative information so that physicians can view examples of the clinical care their patients receive in relation to the average care and costs of their peers.
We just received the following notice, which will allow you to look up your own QRUR. It is the intent of Congress and CMS to more closely tie payment for medical care to value – for beneficiaries and for Medicare. In defining value, CMS expects to weigh quality more heavily than efficiency.
Authorized representatives of groups or solo practitioners can access their QRUR report using a valid user ID and password. All of the information you need to access your data is found in the notice entitled “2013 quality and resource use reports (QRUR) are available.”
We encourage you to access your individual data and to examine it carefully. CMS has prepared a slideshow which explains this program and associated data in much more detail. Because this initiative, along with other incentives or penalty programs, could begin to have a significant effect on your income, even if you do not have a lot of Medicare patients, we urge you to pay attention to this report.