Medicare demonstration project begins this month
By Hillel Kuttler, reporter/editor, AAPA News
The Centers for Medicare and Medicaid Services (CMS) will launch a demonstration project that will reward small and medium-sized medical practices for implementing information technology (IT) that helps improve the care of chronically ill Medicare patients. The Medicare Care Management Performance (MCMP) project will pay physicians and practices for meeting and exceeding 26 quality measures in their care of patients with diabetes, heart failure, or coronary artery disease and in providing preventive care. Applications will be sent to 800 practices that CMS hopes to recruit for the program by April—250 practices each in California and Massachusetts and 150 each in Arkansas and Utah—said Jody Blatt, CMS project officer for MCMP. The pay-for- performance project will be open to practices of 10 or fewer physicians and will run from next July through June 2010, she said.
The care that PAs provide in those practices will count toward the program's measurements, but PAs are ineligible to receive incentive payments, she said. CMS estimated that $43 million in incentives could be paid, but Blatt stated that according to the statute that provided for the demonstration project, that amount will be “budget neutral,” meaning that it may not exceed what Medicare would have spent on care for those patients anyway.
Council update
By Christopher Doscher, news editor, AAPA News, and Jane Howard, director, communications
Recent meetings of AAPA's Education Council, Professional Practice Council, and Clinical and Scientific Affairs Council included discussions of the following issues:
• The Education Council will prepare a series of articles to help guide PAs through the many issues and
changes that are occurring in the area of CME, including new modalities of CME, professional integrity as
it relates to continuing medical education, professional portfolios, and point-of-care learning. Council
members also continued their review of AAPA's policies regarding the appropriate level of degree for PA
education and discussed the issue of foreign-trained medical graduates seeking to come to the United
States to practice as PAs.
• The Professional Practice Council (PPC) continued discussions on whether PAs should be subject to criminal penalties if they deviate from public health directives, how the rapid expansion of retail clinics will affect patient care, and what professional credentials are appropriate for PAs to list after their names. The council also plans to reaffirm AAPA's policy on specialty certification. (To read the policy, go to www.aapa.org/policy/against-spec-cert.html.)
• The Clinical and Scientific Affairs Council (CSAC) is conducting 5-year reviews of policies regarding Healthy People 2010, emergency medical identification, telemedicine, and prescription pain medication. Each was updated to reflect current technologies and climate, and proposals for the updates will be forwarded to the House of Delegates (HOD). Also, as part of its meeting, CSAC joined the AAPA Committee on Diversity (COD) for a discussion of a paper COD has drafted on sexual reorientation therapies. COD is in the process of discussing the paper with various AAPA groups.
New information updates available online
Approximately 231 million patient visits were made to PAs and approximately 286 million medications were prescribed by PAs in 2006, according to new estimates recently released by AAPA. The report on the Number of Patient Visits Made to Physician Assistants and Number of Medications Prescribed or Recommended by Physician Assistants in 2006 is one of several information updates now available on AAPA's Web site at www.aapa.org/research. Other information includes estimates of
• The mean number of medications that were prescribed per patient visit by PAs working in different specialty categories
• The total number of medications that were prescribed in 2006 by PAs practicing in each specialty
• The number of PAs who are in clinical practice in each specialty and the mean number of patient visits made to PAs in each group
• The total number of patient visits per week made to PAs practicing in each specialty.
Information updates also are available on PA income, fringe benefits, income of 2005 PA graduates, projections of the number of people in clinical practice as PAs as of January 1, 2007, and the number of visits to PAs for selected disorders in 2006. Information from past years also is available.