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Pathologists May Participate in 2008 CMS Physician Quality Reporting Program
November 11, 2007

Two pathology pay-for-performance measures may be applicable for pathologists reporting on quality measures with their 2008 Medicare claims.

The measures received final approval Oct. 18 from AQA, a multi-stakeholder payer-supported organization, and should be included in the final 2008 physician payment rule from the Centers for Medicare and Medicare Services.

"The College is pleased to lead development of pay-for-performance measures for the specialty of pathology," said Jared Schwartz, MD, PhD, FCAP and President of the College. "We are confident our first two measures are based on sound science and promote high-quality health care."

The pathology measures were developed by the College and the American Medical Association Physician Consortium for Performance Improvement, based on CAP breast and colon cancer checklists. AMA designated the College in 2006 as the lead for the development of pathology measures.

Members of various College committees convened a working group in 2006 for ongoing development of measures. Proposed measures undergo an internal review and final approval prior to submission to the AMA Consortium.

From there, the measures are submitted for various external reviews with final approval sought by the AQA. The CAP working group is currently developing measures for 2009 and beyond.

The Tax Relief and Health Care Act of 2006, H.R. 6111, provided up to a 1.5 percent bonus payment for physicians reporting measures in 2007, with $300 million appropriated by Congress for those payments. Because Congress expedited the timeline for approval of measures for 2007, the College concluded that risks outweighed the benefits of prematurely rushing through its measures in 2007 for a very small and uncertain bonus payment that may not serve the interests of pathologists.
Though the bonus in 2008 will be based on reporting on the measures, not performance, CMS plans to make the performance data publicly available.

"The College will continue to proceed with cautious optimism while it develops further measures for consideration," Schwartz said.

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