Two New HCFO Grants Announced

Title: The CMS Pay for Performance Initiative: Are Some Quality Scoring Methods Better Than Others?
Grantee Institution: Massachusetts General Hospital Institute for Health Policy
Principal Investigator: Joel S. Weissman, Ph.D.
Grant Period: March 01, 2007 – August 31, 2008
Paragraph Summary: The researchers will examine the quality of hospital care. Using patient-level data from a large sample of hospitals collected by the Hospital Quality Alliance (HQA), they will estimate the proportion of patients receiving recommended care, create new measures of patient care quality, and simulate the impact of several pay-for-performance (P4P) scoring methods on hospital rankings. They will also examine the extent to which care varies by race, ethnicity, or insurance status within and across hospitals. The objective of the study is to assist CMS, other public and private payers, and accrediting organizations in developing strategies to improve hospital performance measurement and payment methods, and, ultimately, the quality of patient care.

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Title: Physicians' Responses to Variations in Medicare Fees for Specific Services
Grantee Institution: Center for Studying Health System Change
Principal Investigator: James D. Reschovsky, Ph.D.
Grant Period: March 01, 2007 – June 30, 2008
Paragraph Summary:  The researchers will examine how physicians’ provision of specific medical services to Medicare fee-for-service (FFS) beneficiaries responds to variations in Medicare physician fees for those services, physicians’ characteristics, and to local market factors. The study will test whether the quantities of specific services physicians provide to their Medicare FFS patients are:1) positively related to the Medicare fee for each service; 2) inversely related to the fees paid by private insurance and to the level of demand from non-Medicare patients; and 3)positively related to indicators of physicians’ incentives to “induce demand.” Potential outcomes include: 1) indicating the percentage change in service volume for a particular fee change; 2) estimating how service volumes vary with local market conditions; 3) characterizing physician opportunities and underlying incentives to induce demand; and 4) identifying services for which service-specific fee adjustments might be an effective tool to constrain unnecessary use. This project expands upon a previous study by the applicants that investigated overall provision of total Medicare services by physicians. The objective of the project is to fill a gap in past and current physician payment research by assessing if changing relative prices of specific services will contribute to meeting the broad policy goals of discouraging the provision of services that unnecessarily add to cost growth without improving quality or outcomes.
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