McCaughey’s response to reporting on her falsehoods includes falsehood
September 08, 2009 5:53 pm ET by Matt Gertz
In a press release issued over the weekend, serial health care misinformer Betsy McCaughey responded to New York Times reporter Jim Rutenberg’s article on her often fact-free commentary about health care reform. She did so, of course, with a falsehood about the House health bill:
The bill's partisans say the consultation sessions are voluntary. But if there is a penalty for noncompliance, then it is not voluntary, regardless of whether the word mandatory used. The penalty is on page 432. Doctors' quality ratings will be determined in part by the percentage of the doctor's patients who create a living will and the percentage who adhere to it. (And quality ratings affect a doctor's Medicare reimbursement)
Jon Stewart disputed this claim during his interview with McCaughey, saying that “It would be really wrong if that was in any way what this said.” As we noted at the time, the bill’s language does not impose a "penalty" on doctors, but rather provides incentive payments for doctors who provide the Department of Health and Human Services with "data on quality measures" for end-of-life care – regardless of the results they report. Media outlets who consider offering McCaughey a platform to discuss health care reform should be aware that she is just going to spout falsehoods.
In order to get the 2% bonus, doctors have to meet certain criteria. There are 100 criteria, and doctors would have to meet just a few. One of the criteria is having end of life counseling. It is just one. In other words, doctors could not do end of life counseling and still get the bonus.
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She claimed that we failed to note a section of the bill that she says sets up a "penalty" for doctors who fail to give patients such advice and that "if thereâs a penalty, it is mandatory." But sheâs actually pointing to a section that would make "quality measures of end of life care" one of more than 150 quality-of-care factors to be considered when awarding physicians a 2 percent bonus under Medicare. And physicians only have to report on a small subset of the measures in order to receive the bonus. Thatâs a far cry from creating a specific penalty for failure to counsel patients, much less making consultations "mandatory," as McCaughey originally claimed.
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It includes 153 quality measures for this year and seven "measures groups."
Not all of the measures apply to all physicians, and doctors may not need to report on all of the measures that do. A CMS spokesman told us that medical professionals decide whether they want to report individual measures or measures groups. To qualify for the incentive payment, a professional must report on "at least 3 measures" or one of the seven groups. Also, CMS told us that the incentive payments are based on whether physicians report data, period â not on what type of data they report.
There is the possibility of not getting a bonus if you don't meet some standard(s) that may be determined by some consensus committee which is then sent out for public comment.
We need an expert on PQRI to properly explain this. Google pqri.
Here's one.
http://www.acr.org/SecondaryMainMenuCategories/quality_safety/p4p/FeaturedCategories/QI-News/PQRIBonusPayment.aspx
PQRI is the Physician Quality Reporting Initiative.
Already, there is up to ??? a 2% bonus of a doctor's medicare billings (by procedure or globally?) if a doctor sends in a report showing that 80% of their patients have met a standard. PQRI reporting is not neutral. You get the money if you report that in 80% of your patients (or patients who have a condition such as diabetes) the doctor has done the following procedures or the doctor's diabetes patients have some level of blood sugar improvement.
Pqri is the start of paying doctors for how well they manage the care of their patients. Already, there are a lot of things that if doctors meet the 80% rule, can contribute to getting part of the 2% bonus.
Under s.1233, a consensus committee was to see if they could come up with some way of measuring advance consultations and then whether these advance consultations had been actually carried out. If a consensus committee created some measurements, then it went for public comment. At the end of the day, there's some additional measurements that if doctors met them could get them some more money.
And eventually, doctors who met the measurement in 80% of their medicare patients and sent in a report saying they'd met the 80% standard could get a bit more money.
Below, you'll find the wording from s.1233.
The process of determining what would be measured would be done by a consensus committee and then subject to public comments. My guess is that this part of s.1233 was just boiler plate they shoved in whenever they were adding some new benefit to medicare.
The idea of qpri is to set out easily understood standards to be met. For example, 80% of my patients with high blood pressure have blood pressure of some numbers or less.
I can see a qpri for advance consultations that goes --- have asked 80% of my patients eligible for advance care consultation as a medicare benefit if they're interested in having me do it with them I'm not sure there ever would be a simple way of measuring whether 80% of patients had their advance care declaration followed out.
I don't know how the money would work out. I'd guess it would be very small.
Section 1233 embodies the belief that advance care declarations are a good idea and that's why they'll be funded. Does this put pressure on a doctor to do them? Not any more that any of the many other pqri measurements.
And the compliance measurements, if they were ever created, wouldn't care what was in the advance care document, but only if what was there was carried out. To believe otherwise, one has to be more politically naive imbecile. That ain't McCaughey.
`(3) Physician'S QUALITY REPORTING INITIATIVE-
`(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.
`(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.'.
Drama politics has hit its stride. Comedy and tragedy have melded into the political arena. Betsy McCaughey, is a traveling circus. Her fictitious ramblings are welcome at the behest of conservative media. Try touring with the truth, and see how far that will get you.
I want a balloon, and cotton candy, while laughing at her freak show, or is she a bad dream?
It be it,
Ronin Kannushi.