Physicians are struggling to meet the targets set by the CMS' Physician Quality Reporting Program, and large numbers could see their future Medicare payments docked as a result, according to a study.
Despite growing participation in the PQRS program since its inception as a pilot in 2007, fewer than one in five eligible and participating providers actually qualified for an incentive payment, according to the study
, released by the American College of Radiology's Harvey L. Neiman Health Policy Institute.
The institute found that radiologists fared better than other physicians, with nearly 24% qualifying for bonuses in 2010 compared with 16% of nonradiologists, the study found.
Under the PQRS program, physicians choose a minimum of three measures from a list of more than 200 and report on at least 80% of their Medicare patient encounters involving each measure. Bonus payments have decreased incrementally each year, dropping from 2% in 2009 to 0.5% in 2013.
Those carrots will soon become sticks as PQRS penalties kick in starting in 2015, when physicians face a 1.5% payment penalty for failing to meet reporting requirements. This year, 2013, is the performance period that will determine 2015's penalty, which makes physicians' lackluster progress so worrisome.
"Near-term improvements in documentation and reporting are necessary to avert widespread physician penalties," Dr. Richard Duszak, the institute's CEO and senior research fellow and the study's lead author, said in a news release
. Radiologists could face as much as $100 million in penalties in 2016, and that number could spike to as much as $1 billion for nonradiologists, he added.
"Compliance with PQRS requirements has improved each year, but more physicians need to act now: Their performance in 2013 will dictate penalties for 2015," Duszak said.