Over the past five years, the Centers for Medicare and Medicaid Services (CMS) has provided physicians with an opportunity to earn bonuses for participating in the Physician Quality Reporting System (PQRS), formerly the Physicians Quality Reporting Initiative.
However, many groups have missed the chance to collect the incentive because they have been under the mistaken impression that the data collection effort is as difficult as it was when PQRS was launched in 2007. They aren’t aware that CMS overhauled the program, making it much easier for doctors to earn the money by streamlining requirements and enabling them to submit data to the agency via approved registries.
Despite an impressive turnaround and enthusiastic reports about the current process from many practices, some groups still don’t participate in the PQRS program based on outdated perceptions. The good news is that it is not too late to qualify for the significant incentives that are available under the 2011 PQRS program. While practices must report on care provided for the year ending Dec. 31, 2011, the deadline for submitting data to CMS for physicians using an approved registry reporting option isn’t until March 30, 2012. The Covisint DocSite registry will accept this data through March 2, 2012, and possibly later; other registries typically have earlier deadlines.
Consider the following misconceptions about PQRS that have kept some small- and medium-sized practices from participating in PQRS:
- PQRS quality measures are designed for large groups. Not so. That’s like saying that only large groups can deliver high-quality patient care. The quality measures groups are designed to evaluate compliance by individual physicians, not an overall practice, and it’s not mandatory for all physicians within a group to select the same quality measures group.
- Only practices using an electronic medical record (EMR) can participate. Not true. PQRS participation is open to all physician practices regardless of whether they are paper-based, in the process of converting to an EMR or are completely digital.
- Every doctor within a group must participate. That’s wrong since physicians qualify individually for PQRS incentives. If a practice has more than one physician, all or some of its doctors can participate.
- The practice can’t qualify for 2011 PQRS incentives because it is already seeking incentives for demonstrating meaningful use (MU) for electronic health records or electronic prescribing (eRx). That’s incorrect. These are separate programs. Practices can earn incentives for PQRS and either MU or eRx in 2011.
- There’s no reason to participate. False. Doctors can earn 1.0 percent of their total estimated Medicare Part B Physician Fee Schedule allowed charges in 2011 and 0.5 percent annually from 2012 through 2014. Additionally, CMS will penalize non-participants by cutting Medicare reimbursement rates beginning in 2015, so it makes sense to reap the rewards now and avoid penalties later.
John Haughton, MD, MS, is chief medical information officer of Covisint, a Compuware company, which enables information ecosystems that provide secure communication and collaboration between people and systems.