The Centers for Medicare and Medicaid Services paid out more than $92 million to 85,000 physicians under the 2008 Physician Quality Reporting Initiative (PQRI), a large boost from the $36 million doled out in 2007.
Approximately 56,700 more physicians were eligible for the incentive payments in 2008, up about a third from 2007 during a six-month reporting period. Last year, the program expanded to allow reporting for either a six-month or a 12-month period.
“We are very pleased with the results for 2008,” said Charlene Frizerra, Acting CMS Administrator. “More health professionals have successfully reported data, and the substantial growth in the national total for PQRI incentive payments demonstrates that Medicare can align payment with quality incentives.”
Established in late 2006 by the Tax Relief and Health Care Act, PQRI is a voluntary program that allows physicians and other eligible healthcare professionals to receive incentive payments for reporting data on quality measures related to services furnished to Medicare beneficiaries.
In the initial program years, those who satisfactorily submitted quality data were able to receive incentive payments of 1.5 percent of the total estimated allowed charges under Medicare Part B for covered professional services. The average incentive amount for individual professionals last year was over $1,000, with the largest payment to an eligible professional totaling over $98,000.
More than 162,800 professionals participated in the 2008 PQRI. Of those, over 85,000 of them met statutory requirements for satisfactory reporting and are receiving incentive payments.
“We are not surprised that more eligible professionals participated and qualified for higher payments under the PQRI in 2008,” said Barry M. Straube, MD, CMS Chief Medical Officer and Director of the Agency’s Office of Clinical Standards & Quality. “For the 2008 program year, CMS made a concerted effort to include as many provider types, and as many medical specialties, as possible in our menu of PQRI quality measures to assure that we were capturing the full spectrum of the health care services that Medicare beneficiaries receive.”
CMS also worked with national stakeholder groups to make improvements in the program from 2007 to 2008 and promoted education and outreach efforts to support eligible providers in participation.
Health practices with participating eligible providers in Florida and Illinois received the highest incentive payments for the 2008 PQRI. In Florida, eligible professionals received a total of over $7.5 million, and in Illinois, they received over $6 million.
In 2008 Congress extended the PQRI under the Medicare Improvements for Patients and Providers Act (MIPPA) and authorized incentive payments through 2010.
Beginning in 2009, Congress increased the incentive that eligible professionals could receive for satisfactorily reporting data from 1.5 percent to 2.0 percent of the estimate of the allowed charges under Medicare Part B for all such covered professional services furnished during the applicable reporting period for 2009 and 2010. CMS also added 52 new quality measures for the 2009 PQRI year, raising the total number of measures to 153.