Eight Ophthalmologic Measures Approved by AMA Physician Consortium

WASHINGTON, D.C. - The American Academy of Ophthalmology has taken a major step toward allowing ophthalmologists to participate in Medicare pay-for-performance differentials, provided Congress passes legislation this year.

Pending versions of Congressional SGR fixes would establish differentials for reporting on quality measures, including a version that would take effect as early as 2007.

On Oct. 6, eight ophthalmologic measures, including those for glaucoma, AMD, diabetic retinopathy and cataracts, were approved by the American Medical Associations Physician Consortium for Performance Improvement (PCPI)®.

The Academy, partnering with several other ophthalmic organizations, increased the likelihood of eye care inclusion in any quality reporting bonus pool that might be created.

"The Academy's goal is to facilitate a mechanism for ophthalmologists to participate in the financial differentials for quality reporting that may be offered under Medicare payers," said William L. Rich, MD, health policy director at the Academy.

In early 2005, the Academy increased its development of quality measures in response to congressional calls for physicians to lead, as well as the prospect of financial differentials being available.

Funded by a grant from the Centers for Medicare & Medicaid Services, the measures were jointly developed by the AMA's PCPI, and the Academy's Eye Care Work group, co-chaired by Paul P. Lee, MD, JD, and Jinnet B. Fowles, PhD.

"Ophthalmology was able to move quickly in measurement development because the Academy's PPPs/Preferred Practice Patterns offer the evidence review that is essential for effective quality targets," said Dr. Lee. "In addition, our colleagues who were nominated by their societies for the work group and throughout ophthalmology played critical roles in ensuring the fairness of the eight measures."

The PCPI will submit the measures for approval to the two validation organizations recognized by CMS: the National Quality Forum (NQF) and the Ambulatory care Quality Alliance (AQA).

On Oct. 4, the Surgical and Procedures Workgroup of the AQA recommended the approval the eight ophthalmologic measures as tests for approval by the entire AQA later this month. If approved, they could also be included in CMS's Physician Voluntary Reporting Program (PVRP), at the beginning of 2007.

The PCPI is committed to enhancing quality of care and patient safety by taking the lead in the development, testing and maintenance of evidence-based clinical performance measures for physicians.

It is comprised of more than 100 national medical specialty and state medical societies including: the Council of Medical Specialty Societies, American Board of Medical Specialties and its member-boards, as well as experts in methodology and data collection, the Agency for Healthcare Research and Quality and CMS.

###

About the AAO
The AAO is the world's largest association of eye physicians and surgeons ??‚??€œEye M.D.s. - with more than 27,000 members worldwide. Eye health is provided by three "O's" - opticians, optometrists and ophthalmologist. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.