News Briefs: Week of Nov. 16-20

This roundup includes the following news briefs:

The cost of a House bill currently under consideration that focuses solely on replacing the flawed sustainable growth rate, or SGR, formula would be $35 billion less than a previous SGR measure contained in the original House health care reform bill, according to the Congressional Budget Office (24-page PDF; About PDFs), or CBO.

The CBO estimated that an SGR fix contained in the original House health care reform bill would have cost $245 billion during the next 10 years. But the stand-alone bill, H.R. 3961, would cost about $210 billion during the next 10 years, $35 billion less than the measure in the health care reform bill, according to the CBO. The cost difference is a result of removing physician-administered pharmaceuticals from the calculations used in the payment formula and differences in rates used for Medicare Advantage, Medicare's managed care program.

A total of 13 primary care practices in the Kansas City, Mo., area have been chosen by Blue Cross and Blue Shield of Kansas City and TransforMED LLC, a wholly owned subsidiary of the AAFP, to participate in a patient-centered medical home, or PCMH, pilot project.

According to a Nov. 12 announcement from TransforMED, the medical groups will have access to TransforMED's practice facilitators during the two-year project to help physicians and their staff members implement various components of the medical home model.

Blue Cross and Blue Shield of Kansas City is funding the project in an effort to identify costs and benefits of the PCMH. Spokespersons for the participating practices said implementation of the patient-centered model of care would improve the quality of health care they provide patients.

According to CMS, more than 85,000 physicians and other eligible professionals received more than $92 million based on their participation in the 2008 Physician Quality Reporting Initiative, or PQRI.

As reported in a Nov. 13 CMS news release, the average incentive amount for individual professionals was about $1,000; the largest payment made to an eligible professional was more than $98,000. CMS also noted that the number of individuals who met the requirement for reporting and who earned an incentive payment increased by 30 percent from 2007 to 2008.