Dear Dr. Williams,
I have read the 263 page H.R. 2 bill already passed by the House of Representatives and currently awaiting Senate vote. Make no mistake, this bill allows the Centers for Medicare and Medicaid Services (CMS) and its Secretary to rank/score doctors using its own quality determination methods, and these scores will be used to adjust physician payment.
I’m embarrassed that the ACC, a physician professional society for which I’ve been a member, and who has dedicated itself to advancing quality, would support any bill that allowed the government to continue its futile attempt to measure it. Every single quality metric [Meaningful Use, Electronic Health Records (EHR), Physician Quality Reporting System (PQRS)] that the government has implemented in recent years has been an absolute disaster in practice. The government has established no credibility in this regard, and absolutely no leniency should have been granted to them in H.R. 2.
In fact, the government-established quality metrics mentioned above have contributed almost nothing to advancing quality in medicine, and in many instances, they have actually stifled it by adding meaningless bureaucratic requirements which continue to drive up third-party healthcare costs.
What the ACC political activists should be lobbying for is the elimination of the government entirely from its value-measuring disaster. Who in the world really thinks that the government is the best entity to manage and define healthcare quality in this country? Who thinks that? Not one physician I know. And, most of the ones that I know are also your constituents.
Yet, our physician professional societies have demonstrated little backbone on the political front regarding the one issue that is well-agreed upon by every physician on the front lines: The single fact that CMS has no business being involved in “measuring” or “scoring” physicians.
It’s the eleventh hour, and the “DocFix” is not a fix at all. Maintenance of Certification (MOC) is a disaster and by itself contaminates the Clinical Practice Improvement Activities also being forced upon doctors by H.R. 2.
In conclusion, the entire physician scoring system outlined in H.R. 2 should be expunged until the MOC crisis and CMS’s well-established quality assessment disaster are rectified. This, Dr. Williams, is what nearly all your physician members still actually practicing medicine would want, if they too had been able to break away from their busy clinical schedules to read H.R. 2 in its entirety.
Rocky D. Bilhartz, MD, MBA, FACC, FSCAI
Interventional Cardiology & Cardiovascular Disease