29% Participation Rate for Medicare Quality Reporting Program Signals Concern

Fewer than 200,000 out of more than 600,000 eligible physicians reported measures for CMS' Physician Quality Reporting System in 2010 — a worrisome finding since the program will turn punitive in 2013, according to an American Medical News report.

The PQRS provides incentive payments to physicians who report data on 144 individual quality measures. CMS provided a 2 percent incentive bonus in 2010. That will fall to a 1 percent incentive payment in 2011 and 0.5 percent incentive payment in 2012 through 2014. Beginning in 2015, physicians face a 1.5 percent cut to their payments as a penalty if they do not participate in the program, but that cut will be based on whether physicians report in 2013.

According to CMS data, only 181,542 of 623,077 — or 29 percent — of eligible physicians participated in PQRS in 2010. That is still greater than the 25-percent participation rate in 2009 but has many experts concerned that the majority of physicians are headed for a penalty.

Some medical groups are urging CMS to not base the 2015 penalties on next year's participation, citing barriers to reporting and other quality and information technology deadlines.

American Medical Association President Peter W. Carmel, MD, said in the report many physicians do not realize the 2015 penalties will be based on 2013 performance in the program. "CMS data show that many physicians are not yet participating in the PQRS program. A significant number of those who are trying have been unable to participate, showing that barriers to success still remain," Dr. Carmel said.

More Articles on Physician Quality Reporting:

CMS Report Shows Growth in Physician Quality Reporting System and e-Prescribing Program
Physician Groups Ask CMS to Re-Evaluate Deadlines for Programs and Penalties
8 Misconceptions About the Physician Quality Reporting System


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