Offering doctors more money and better quality measures are the way to get greater participation in the Physician Quality Reporting Initiative, industry representatives believe.
Just 16% of eligible providersonly 99,000 physicians, nonphysician practitioners or therapistssubmitted this data at least once in 2007, according to preliminary data released by the CMS last week on the PQRI. The voluntary program last year offered a bonus of 1.5% of total allowed charges for covered Medicare physician fee-schedule services payment to practices that reported claims on a designated set of 74 quality measures. The agency doesnt know yet how much money it will be paying out to physicians for 2007 because some are still reporting, according to a CMS spokeswoman.
Whether the program will continue to attract physicians depends on what the CMS puts behind it in terms of potential bonuses, said Bruce Auerbach, vice president and chief of emergency and ambulatory services at 128-bed Sturdy Memorial Hospital, in Attleboro, Mass., past chairman of the American College of Emergency Physicians Quality and Performance Committee and a PQRI participant.
CMS acting Administrator Kerry Weems said in a letter to Senate Finance Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) that the CMS would move quickly to encourage broader participation by physicians and other eligible professionals. The preliminary findings reflect data collected from July 1, the start of last years reporting period, through November 2007. A Medicare reform bill approved last year extended PQRI through 2008, and the reporting period will span the entire calendar year. The bonus payment, however, is still set at 1.5% for reporting on a portion of an expanded set of 119 measures.
Christine Cassel, president and chief executive officer of the American Board of Internal Medicine, said that the PQRIs reporting method doesnt reflect whats taking place in primary-care practices, and thats why the voluntary program isnt attracting those types of doctors. Most of the higher-earning specialties, not primary-care doctors, are benefiting the most from PQRI, she said. Cassel said the CMS should restructure its measures to more accurately reflect the needs of the complex Medicare patient and what primary-care doctors are doing in their practices, instead of just single disease or laboratory outcomes.
Some physicians saw a silver lining in the initial PQRI results. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians, believes the push for these types of incentives will grow. Granted, the 1.5% bonus is a modest incentive for a family doctor, who grossed perhaps $400 to $1,500 for the six-month reporting period last year, and who might double that amount for participating for all of 2008, Bagley said. However, given that its not that much money and that performance measures are still in their infancy, 16% is a pretty significant response.