PQRS participation increases, but nearly 470k will be penalized

CMS saw a 47 percent increase in participation in the Physician Quality Reporting System from 2012 to 2013, but nearly half a million eligible professionals will be subject to a financial penalty this year, the first year such penalties exist.

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Based on the 2013 reporting data, physicians are now subject to a negative payment adjustment if they do not satisfactorily report data on quality measures for Physician Fee Scheduled services provided to Medicare Part B fee-for-service beneficiaries. In 2013, 469,755 eligible professionals were subject to a PQRS negative payment adjustment of 1.5 percent of their 2015 Part B Medicare Fee Schedule allowed charges.

Of the physicians subject to the penalty, 98 percent did not attempt to participate in PQRS, according to CMS. Many such professionals (43 percent) treat 25 or fewer Medicare beneficiaries each year.

On the flipside, many eligible professionals earned incentive payments due to their participation in PQRS — incentive payments totaled $214,551,741 for 2013 PQRS. According to an AHA News Now report, about four in 10 eligible professionals earned a PQRS incentive payment.

CMS also saw a 9 percent increase in participation in the e-prescribing program from 2012 to 2013.

More articles on quality reporting:
CMS’ new hospital rating system: 5 things to know about calculating the star ratings
Stakes are rising for clinical quality: How to get the metrics right
CMS releases ‘report once’ guidelines for providers

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