WASHINGTON—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 chose to accept pay cuts rather than participate in the quality reporting system.
The agency issued a new report on the programs late last week. The numbers come as the CMS and physicians prepare for the PQRS to be rolled into what is 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 reduced pay through the e-prescribing program. In both cases, the most common reason for getting dinged was a refusal to take part: 98% of PQRS reductions and about 80% of e-prescribing adjustments were attributed to nonparticipation.
But the numbers of professionals who are participating has steadily increased. The total of participating eligible providers in the PQRS program reached 1.25 million in 2013, capturing 51.2% of eligible professionals.
And 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.
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.