Practice Matters

News from Lola Butcher about health policy and practice management issues of importance to oncologists

Tuesday, January 4, 2011

Accountable Care for Oncologists: The Importance of ‘Transparency’

If you are reading this, I salute you. Oncologists need to learn about the accountable care movement because it is the future of health care.

As I discussed yesterday, the first step to preparing for the accountable care organization, or ACO, era is embracing the attitude that physicians who provide good care should be paid more than those who do not. In other words, patients and payers should hold physicians accountable.


The second step: Embracing transparency.


If you are not already sick of the term “transparency,” you will probably get there because this word will be a relentless drumbeat in the years ahead.


Transparency means going public with hard data that documents the quality of care that your patients receive.


That is a relatively new concept in health care, where most patients think their physicians are great, based on no evidence. Enjoy it while it lasts.


In recent years, government prodding has spurred hospitals to accept transparency as a responsibility. Most leading health systems now post quality scorecards on their websites, even if their scores are cringe-worthy.


As a backup, the federal government posts a steadily growing number of hospital quality measures on its Hospital Compare  website (


This same level of transparency is coming to physician practices, courtesy of payers’ interest in accountable care. So oncologists must get used to reporting data about their performance.


The first step is to participate in the government’s Physician Quality Reporting System.

As OT reported last year, most oncologists have avoided this program on the grounds that it is confusing, time-consuming, irrelevant and frustrating and the potential bonus was not worth the effort.


All those complaints are probably justified. But note that the program’s name has changed from the Physician Quality Reporting Initiative to the Physician Quality Reporting System; it is now a permanent program.


Just because physicians have ignored it does not mean it will go away.


We can hope that PQRS will get easier and more relevant over time. In the meantime, oncologists should start participating so they learn how to successfully report (it is not easy) and they understand how the program evolves.


Currently, PQRS is a pay-for-reporting program, meaning the bonuses are awarded for reports submitted in the way the Centers for Medicare & Medicaid Services wants them to be submitted. Nobody looks at the data to evaluate the quality of care provided.


But eventually the program will become a pay-for-quality program. When that day comes, you do not want to be trying to figure out what PQRS is all about and how to report your data correctly.


Some would say there is no downside to avoiding PQRS currently. I say there is no downside to participating in PQRS, other than the frustration and time involved in learning how to do so.


That learning curve is going to happen some time. That should be this year, so your practice is more prepared to deliver accountable care.


What to Do Now

Check out CMS's PQRS website.  The “How to Get Started” information needs updating to 2011, and I’m prodding the CMS press office to get on the job.  I will post the link as soon as I see it.


In the meantime, the site has plenty of reading that can help you get acclimated to the PQRS program. CMS offers a lot of education programming -- conference calls for physician practices, manuals, etc. -- to help physicians participate. When I see those coming up for 2011, I will post links here.