1-26-07
Medicare Quality Measures for Occupational Therapy Coming Soon
AOTA is working diligently to address new quality and payment options for Medicare Part B outpatient therapy, which take effect July 1, 2007. The program is entirely voluntary for providers but may be the beginning of a larger program in the future.
Congress created the new quality measures reporting system in December, in the Tax Relief and Health Care Act of 2006, (TRHCA) the same law that extended the exceptions to the cap process. The process will be implemented in concert with the Physician Fee Schedule; bonus payments for positive reporting will be available.
In establishing the new approach, Congress recognized occupational therapists as professionals eligible to participate in the system. AOTA is also collaborating with other rehabilitation organizations to ensure appropriate representation of rehabilitation services in the system.
The system builds on an existing Physician Voluntary Reporting Program and authorizes a payment incentive based upon quality measures reported for care to Medicare outpatient beneficiaries, from July 1 through December 31, 2007. The quality reporting system will provide an approximate 1.5% bonus payment to participants. New and additional measures will be used for reporting and bonus payments in 2008.
AOTA is working closely with the Centers for Medicare and Medicaid Services (CMS) to identify the quality measures for which occupational therapists can provide data, and is meeting with the director of the massive new program to discuss quality reporting initiatives and their effect on therapy services.
Until now, the American Medical Association's Physician Consortium on Quality has been the sole developer of measures. CMS has told AOTA that CMS directed the Physician Consortium to include and address non-physician practitioners. For more
information, see the CMS Web site.
This development is in synch with AOTA's current strategic objective, flowing from the Centennial Vision, to develop publicly understandable outcomes for occupational therapy. Measures for occupational therapy are the goal of an AOTA-member outcomes ad hoc task force currently being established.
AOTA has also been a participant in deliberations of the Ambulatory Care Quality Alliance (AQA), a broad-based coalition of health care providers, consumers, purchasers, health insurance plans, and others working to effectively and efficiently improve performance measurement, data aggregation, and reporting in the ambulatory care setting. The AQA is one of three consensus organizations recognized by Congress in the TRHCA informing the Special Program Office of Value Based Purchasing at CMS. More information on the AQA is available at their Web site.
These latest developments are just the beginning of many payers move to pay-for-performance and measured outcomes systems. Stay tuned to the AOTA Web site for more information as it is made available.
