Physicians awarded more than $92 million by CMS

More than 85,000 physicians and healthcare professionals, who properly reported data regarding Medicare services to the Center for Medicaid & Medicare Services (CMS), reaped more than $92 million in incentives in 2008 under the Physician Quality Reporting Initiative (PQRI).

The amount paid out by CMS was $56 million more than the $36 million distributed in 2007, and the number of those who received incentives increased by one-third—56,700 to 85,000.

PQRI is a voluntary program that allows physicians and other healthcare eligible professionals to receive incentive payments for reporting data on quality measures related to services furnished to Medicare beneficiaries. According to CMS, the incentive amount paid to each receiving individual averaged more than $1,000, with the largest payout totaling more than $98,000.

According to CMS, Florida received the highest incentive payments from the PQRI, totaling more than $7.5 million, with Illinois a close second, receiving more than $6 million.

Earlier this year, Congress increased the number of incentives by .5 percent and added 52 new quality measures to include further healthcare professionals who provide services to Medicare recipients.

“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 healthcare services that Medicare beneficiaries receive,” said Barry M. Straube, MD, chief CMS medical officer and director of the office of clinical standards & quality.

On Oct. 30, CMS released changes to the 2010 PQRI including:

• The addition of 30 individual PQRI measures and six groups on which eligible professionals may report.
• The implementation of provisions conforming to the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) that will enable group practices to participate in the 2010 PQRI based on the group practice, rather than the individual level.
• The addition of an EHR reporting mechanism to promote the utilization of EHRs to give professionals experience with EHR-based reporting.
• Allowing those who “satisfactorily” report data at least three times out of 10 be eligible for incentives.
• The addition of a six-month period beginning July 1 for claim reporting.