McClellan suggested that payment reductions and no increase in premiums could be accomplished in part through savings generated by adopting measures of quality. "There is growing evidence that these quality reporting programs and steps toward performance-based payments can save money overall," he said.

He said that 34 physician specialties have developed measures that doctors could use to report performance data using the current claims they file when they seek reimbursement from Medicare. Only 5 specialties lack such measures, he added.

The event was the second day of a hearing that began Tuesday on the subject of Medicare physician spending. As he did Tuesday, House Energy and Commerce Committee Chairman Joe Barton, R-Texas, again expressed interest in passing legislation this year that would scrap the problematic current payment formula and switch to yearly payment increases based on the change in the Medicare Economic Index (MEI), which tracks the costs of delivering physician care.

To read the entire article, please go to http://www.cmwf.org/healthpolicyweek/healthpolicyweek_show.htm?doc_id=386658&#doc386660.

 Reprinted from The Commonwealth Fund, July 31, 2006 issue.  www.cmwf.org

Loyalty and perception are often looked at for hospitals and health systems, but what about physicians? 

During August 2007, PRC interviewed 1,000 adult healthcare decision-makers about their perceptions, utilizations and loyalty to hospitals and healthcare providers.  Consumer utilization of a physician, group of physicians or clinic for medical care is higher than ever before.  Between 1997 and 2007 the percentage of consumers that have a "healthcare home" increased from 88.5% to 94.1%.

The study also revealed that 15.6% of consumers changed their healthcare home in the past two years.  The main reasons cited for changing physicians included:

• Patients Perception Reasons - 31.4%
• Insurance Affiliation/Billing/Cost - 24.4%
• Location/Doctor Moved - 24.4%
• Clinical Reasons - 10.3%
• Doctor Retired/Passed Away - 9.5%

Considering that almost one-third of patients switched physicians due to patient perception reasons, it makes sense that those patients rated their physician much lower than the national average (22.3% rated the physician excellent vs. 36.9% excellent for national average).

Surprisingly, specialist utilization is down from the past year.  In 2006, 62.0% of consumers reported that they had used a specialist within the past two years.  In 2007, only 56.7% of consumers reported seeing a specialist in the past two years.  The specialists that were most often utilized by patients in the past two years include:

• Orthopedics - 16.5%
• Obstetrics/Gynecology - 10.4%
• Cardiology - 10.3%
• Gastroenterology - 7.0%
• Oncology/Cancer - 5.4%

If you would like more information on consumers' perceptions of physicians and healthcare providers, please contact PRC at info@prconline.com.