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CMS-1403-FC
clarification on which 30 patients should be included in
the consecutive patient sample.
Response: We are pleased that many commenters found
the 30 consecutive patient reporting option to be useful
and were supportive of this option. We agree that a sample
of 30 consecutive patients would be a nonrandom sample, but
it is our intention to allow physicians and other eligible
professionals greater flexibility and opportunities to
participate in PQRI. In addition, requiring consecutive
patients would prevent eligible professionals from being
able to selectively report cases to enhance their
performance rates.
While we do not have the results of the 2008 PQRI
reporting, we believe that a minimum sample size of 30
consecutive patients is sufficient to calculate comparable
performance rates across eligible professionals furnishing
comparable services. Patient sample sizes of 30 are
commonly considered to be a reasonable minimum threshold
for being able to reliably report health care performance
measurement results. Results from our Better Quality
Information for Medicare Beneficiaries (BQI) pilot project
indicate that minimum patient sample sizes of between 30
through 50 patients per physician are needed to make
reliable distinctions between physicians’ performance.
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