The CMS paid out more than $380 million in incentive payments through its physician-quality reporting system and electronic-prescribing incentive programs, but more than 400,000 providers accepted pay cuts rather than participate.
The agency issued a new report on the programs late Thursday. The numbers come as the CMS and physicians prepare for the Physician Quality Reporting System, or PQRS, to be rolled into what's intended to be a more cohesive approach to quality reporting and incentives under the recently enacted legislation repealing and replacing Medicare's sustainable growth-rate formula.
Physicians have long complained of a disjointed and overlapping array of reporting requirements, leading many to conclude that the financial bonuses and penalties tied to them aren't worth the trouble.
Nearly 470,000 physicians and other eligible professionals got a 1.5% reduction in 2015 payments based on their PQRS data, while almost 50,000 eligible professionals saw a reduction in 2014 through the e-prescribing program. In both cases, the most common reason for getting dinged was declining to participate: 98% of PQRS reductions and about 80% of e-prescribing adjustments.
But the number of participating professionals has increased steadily.
The number of eligible providers participating in the PQRS program reached 1.25 million in 2013, capturing 51.2% of eligible professionals.
Specialties with the lowest numbers of eligible professionals failing to participate in the PQRS or meet its requirements included psychiatrists (67%) and general practitioners (65%). Meanwhile pathologists (15% suffering a penalty) and radiologists (20%) were particularly likely to avoid the payment adjustment.
The number of providers participating in e-prescribing climbed from nearly 345,000 in 2012 to just over 377,000 in 2013, the final reporting year for the program. That means 46.6% of eligible providers eventually participated.
The last reporting period for the e-prescribing program was in 2013. The government's incentive program for meaningfully using electronic health records is now the primary mechanism for pushing providers to transmit prescriptions electronically. Those EHR meaningful-use requirements, as well as the value-based modifier, are likewise slated to get rolled into Medicare's new Merit-based Incentive Payment System.
In the CMS' incentive program for using electronic health records, 92% of eligible professionals who attested to meeting the Stage 2 requirements as of April cleared that program's e-prescribing measure, which calls for 50% of prescriptions to be transmitted electronically.