Congress has often intervened to prevent or delay such cuts. It could easily stipulate that doctors must report measures of clinical performance as a condition of getting even a small increase in Medicare fees. AMA leaders said they agreed to help develop uniform measures of the quality of care because otherwise doctors would have dozens of disparate measures foisted on them by insurance companies, health plans and government programs. Thomas Thames, an AARP board member, said his group supported efforts to measure performance and link Medicare payment to quality because "rewarding quality can improve results." He said, "We support moving to pay-for-performance on an aggressive timetable." Dr. Mark B. McClellan, CMS Administrator, said Medicare should reward doctors for "efficiency and high-quality care, not simply pay for more services." But Dr. Stuart L. Weinstein, a University of Iowa professor and President of the American Academy of Orthopaedic Surgeons, said the timetable endorsed by the AMA and Congressional leaders was unrealistic. "Performance measures need to be developed by specialty societies, then tested and validated, to confirm that they really affect patient care in a positive way," he said. 

(New York Times, 2/20/06)