GE Healthcare streamlines CoxHealth's Medicare reporting

More than 30 CoxHealth primary care physicians who volunteered for a Medicare quality reporting program last year are crediting GE Healthcare for keeping potential headaches to a minimum.

Illinois-based GE Healthcare recently was selected by the U.S. Centers for Medicaid and Medicare Services as one of a handful of vendors for the 2008 Physicians Quality Reporting Initiative, which offered financial incentives to participating physicians. GE provides the service through its Medical Quality Improvement Consortium quality data system.

To encourage participation, the voluntary reporting program reimburses doctors up to 1.5 percent of allowed charges for successfully reporting on a specified set of quality measures for patient services covered by Medicare. Next year, the cap will be raised to 2 percent.

Incentives paid to participating physicians nationwide last year totaled more than $36 million, according to a CMS report released in December.

The quality reporting initiative was created in 2006 when President Bush signed the Tax Relief and Healthcare Act passed by Congress, but few physicians volunteered for the program in its first year. Only about 16 percent of eligible physicians participated in 2007, said Dr. Michael Lieberman, MQIC medical director with GE Healthcare.

"It was difficult for the providers to do and difficult for the billers on the back end," he said. "There was a lot of administrative overhead to participating in the program."

Dr. Dan Sontheimer, vice president of medical affairs for CoxHealth, said the program didn't initially allow for electronic data submission, prompting many doctors to balk at the promise of more paperwork.

"You try to make things efficient for patient care," Sontheimer said. "I don't want our doctors, our nurses or our schedulers to have another piece of paper. The process to get a patient through the system is complex enough as it is these days. This was a way that literally they did not have to do anything extra."

CoxHealth has used GE Healthcare technology to manage its electronic medical records since 1997, and in 2006, the hospital network began using GE's MQIC system, said Sontheimer, a family practice physician who leads the residency program at Cox North.

When the federal government certified MQIC as a reporting registry last year, a group of CoxHealth doctors decided to enlist in the reporting initiative. Sontheimer, who is among the participating physicians, said the technology has proven an effective reporting tool.

Each week, MQIC accesses servers where patient data is stored. The IT software then captures records relevant to the reporting criteria and removes personal information before creating a database of the "de-identified" records, Sontheimer said.

"It's so easy," he added. "I sign a release to Medicare that I've agreed to let GE submit data on my behalf, and you pay a $250 enrollment fee. And some time in December, GE ran all the data for the year and submitted it."

Under the program, physicians select five indicators out of more than 150 for data reporting purposes. CoxHealth physicians are monitoring cholesterol, high blood pressure and influenza/pneumonia vaccination rates to name a few, Sontheimer said.

"The end goal from Medicare's standpoint is to make sure you're consistently delivering (services) to Medicare patients," he added.

GE's Lieberman said the process of collecting and aggregating patient records can be challenging because of reporting discrepancies, but he noted that each physician reviews the data for accuracy before it's submitted to CMS. MQIC also allows physicians to compare quality of care for patients with similar health conditions, he said.

"I think this idea of reporting quality data will absolutely grow and become the norm in medicine," Lieberman said. "We're seeing this more and more throughout health care. People are interested in not just paying for quantity of services, but it's really quality as well and trying to measure the value they're receiving when they get health care - and making sure they can optimize that value."

Last year, GE Healthcare provided quality reporting through its MQIC system to roughly 1,000 physicians at about 50 health organizations, Lieberman said.

Sontheimer said he's hopeful more CoxHealth physicians will participate in the 2009 reporting initiative, although he acknowledged skepticism within his industry.

"The physicians - and rightly so - have a jaded view of Medicare, ... but I didn't see anything nefarious in this first year (of reporting)," he said.