Pay for Performance in Chronic Liver Disease

Clin Gastroenterol Hepatol. 2015 Nov;13(12):2042-7. doi: 10.1016/j.cgh.2015.06.038. Epub 2015 Jul 8.

Abstract

With the advent of the Affordable Care Act, pay-for-performance programs have become widespread in the United States and are here to stay. The Centers for Medicare and Medicaid Services started its pay-for-performance program, the Physician Quality Reporting Initiative, in 2007, and made it a permanent system, the Physician Quality Reporting System, in 2011. Although it started off as a pay-for-performance initiative, in which physicians and other health care professionals were rewarded for satisfactorily reporting on selected quality measures, it now has evolved into a penalty-based program. The Physician Quality Reporting System includes measures that target hepatitis C virus infection. It is important for gastroenterologists to be aware of these measures and the submission process to avoid penalties or other difficulties with reimbursement. This review describes the current measures in chronic liver disease, rates of submission, as well as the submission process and associated challenges.

Keywords: Chronic Liver Disease; Pay for Performance; Quality.

Publication types

  • Review

MeSH terms

  • Hepatitis C, Chronic / diagnosis*
  • Hepatitis C, Chronic / therapy*
  • Humans
  • Reimbursement, Incentive*
  • Treatment Outcome
  • United States