Notice: This CMS-approved document has been submitted - Philips ...

CMS-1403-FC
two program sites: Baltimore, MD (August 2008) and Boston,
MA (September 2008). Baltimore was selected as a program
site due to its close proximity to the CMS central office
and Boston was selected as a program site due to its high
per capita Medicare costs and utilization rates. 8 We refer
readers to a detailed discussion of the Baltimore and
Boston program sites below. Any additional Phase I
activities completed for the Physician Resource Use
Feedback Program will be similar to activities completed in
Baltimore and Boston, including the same methodologies for:
(1) choosing additional program sites, (2) recruitment of
physicians, and (3) construction of RURs. We are
implementing Phase I of the Physician Resource Use Feedback
Program on an interim final basis with comment period and
it is CMS’ intent to propose subsequent phases of the
program through rulemaking.
As indicated above, section 1848(n)(1)(B) of the Act
requires section 1848(n)(1)(B) of the Act, requires that
the physician resource feedback program address resources
measured on: (1) an episode basis; (2) a per capita basis;
or (3) both an episode and a per capita basis. The RURs
used in the Baltimore program site used a per capita
analysis for measuring cost of care and the RURs used in
8
Dartmouth Atlas of Healthcare. 2005 Medicare reimbursement figures derived from Hospital Service
Area (HSA).
794