I joined the many that have been incensed by Betsy McCaughey's "interview" on the Daily Show last night. A more potent example of the way opponents of health care reform will spin and obfuscate facts to drum up fear and opposition I haven't yet seen.
McCaughey certainly knows full well what the Physician Quality Reporting Initiative is, and how the paragraphs in HR 3200 discussing end of life measures are talking only about the VOLUNTARY data collection undertaken by this program.
Still I have to thank her and Jon, because amidst all the furor over "death panels" I hadn't seen anyone point to the exact legislative paragraphs that led to this "belief"
For the uninitiated, here's a good place to start
http://www.cms.hhs.gov/...
The part of the legislation addressing this has been posted in other areas, but here it is again, just for reference..
b) Expansion of Physician Quality Reporting Initiative for End of Life Care-
(1) Physician'S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:
`(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.'.
The important points:
- PQRI is entirely VOLUNTARY
- Physicians are paid an annual 2% BONUS for participating in the program as a whole, there are no penalties.
- PQRI is data collection only. It does not make treatment recommendations, offer advice of any kind, or negatively or postively impact reimbursement (except for the bonus payment made for participating physicians)
- The bonus payment is made based on participation and the physicians can choose the measures they want to report on. If they don't want to report on any measure, they don't have to.
- PQRI does not track outcomes. I.e., it does not track whether a certain treatment was successful or not. It only captures data on numbers of people. See below for some examples.
- The language in HR3200 only sets out the intent that end of life treatment discussions should be included in the PQRI.
The PQRI currently tracks 186 measures, some of which include
Measure 3 : Percentage of Diabetes patients who had most recent blood pressure measurement in the "controlled" range (i.e. less than 140/80)
Measure 6: Percentage of patients 18 yrs and older with a diagnosis of Corornary Artery Disease who had Oral Anti-Platelet Therapy prescribed.
Measure 28: Percentage of patients with an ER discharge dx of Acute Myocardial Infarction who had documentation of receiving Aspirin within 24 hours before ER dept arrival or during ER stay.
Etc. etc. You can go read all 186 measures at the CMS link above.
To pretend that the measures for end of life care under that would be established under the PQRI program are in any way designed to deny care for terminally ill people is uninformed at best, but is more likely a serious deception by opponents of reform designed to sieze on a complicated CMS program that would be poorly understood by the general public.
I am ashamed at the Senate for removing this provision based on the loud ignorance of a few people directed by those with a vested interested in making sure no healthcare reform at all occurs.