Most hospitalists vividly recall Congress overriding President Bush’s July veto to avert a hefty, 10.6% cut in Medicare Part B payments to physicians. That memorable, last-minute save (instead of a pay cut, Congress increased Part B payments by 1.1%) was just a tiny part of some important legislation. The Medicare Improvements for Patients and Providers Act (MIPPA) includes myriad provisions addressing Medicare benefits, protections for low-income beneficiaries, changes for providers, data collection requirements for correcting healthcare disparities, and much more.
Hospitalists will be particularly interested in a handful of the provisions outlined in MIPPA, some of which impact them directly and others that will affect hospitals and clinical care, and still more whose outcomes remain to be seen.
For example, MIPPA is the legislation that extends the Physician Quality Reporting Initiative (PQRI) for two years, offering a bonus payment in 2009 and 2010 of 2% (up from 1.5%) of total Medicare allowed charges. It also directs the Centers for Medicare and Medicaid Services (CMS) to publicly post the list of providers who participate in the PQRI. (See “A Permanent PQRI” in the October 2008 issue of The Hospitalist.)
MIPPA also requires CMS to establish a program to promote widespread adoption of electronic prescribing, as outlined in “e-Prescription for Success?” in the September 2008 issue of The Hospitalist. Reporting on e-prescribing is not likely to apply to hospitalists, says Bradley Flansbaum, DO, MPH, chief of hospitalist section at Lenox Hill Hospital in New York City and a member of SHM’s Public Policy Committee. “Of course, it depends on whether the hospital uses it, but no one can say whether a hospitalist will get a benefit for reporting on e-prescribing,” he says.