Congress asks CMS about pay-for-performance initiatives

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Congressional leaders have asked the Centers for Medicare & Medicaid Services to detail the agency's pay-for-performance (P4P) initiatives, and suggest ways financial incentives could increase provider participation and improve healthcare quality. All this may result in more scrutiny of the use of pay-for-performance in the nursing home sector.

House Ways and Means Committee Chairman William M. Thomas (R-CA) and health subcommittee chairwoman Nancy L. Johnson (R-CT) sent a letter to CMS Administrator Mark B. McClellan last week: "Today, Medicare pays providers the same whether they deliver excellent care or care that is ineffective, poor quality or out-of-date," Thomas and Johnson wrote.

Previously, the Medicare Payment Advisory Commission has recommended that Medicare pay providers who deliver quality care between 1% and 2% more than other providers.

In March a coalition of 15 of the nation's largest skilled-nursing care providers expressed their support for legislation that ties Medicare payments to the quality of care provided in long-term care facilities.