Press Releases

Participation Rises in Medicare Physician Quality Reporting System and Electronic Prescribing Incentive Program

Participation Rises in Medicare Physician Quality Reporting System and Electronic Prescribing Incentive Program

The Centers for Medicare & Medicaid Services (CMS) today released the 2012 Physician Quality Reporting System and Electronic Prescribing (eRx) Experience Report, showing a significant increase in participation in two key programs that allow eligible professionals to earn incentive payments through voluntary participation.

“Our physician and other clinician quality programs reached new records this year with over 430,000 professionals participating in the Physician Quality Reporting System and over 340,000 e-prescribing,” said Patrick Conway, M.D. deputy Administrator for innovation and quality and chief medical officer at CMS. “Clinicians are actively measuring and reporting on quality, and CMS is in the beginning stages of adding this information to the Physician Compare website, which can be viewed by patients. Measuring, transparently sharing, and improving quality performance is key to a better health system.”

The full report can be found at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2012-PQRS-and-eRx-Experience-Report.zip

The Physician Quality Reporting System (PQRS) has been using incentive payments, and will begin to use payment adjustments in 2015, to encourage eligible health care professionals to report on designated quality measures. The Electronic Prescribing (eRx) Incentive Program used a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals.

Increased participation in 2012

The 2012 report found that there was increased participation in both PQRS and the eRx Program, marking progress in CMS’s efforts to improve quality measurement, as well as to build a national electronic health information infrastructure in the United States.

Report highlights include:

• Participation in the PQRS program increased by 36 percent from 2011.
  In 2012, 435,931 eligible professionals participated as individuals and as part of group practices in PQRS, through at least one reporting method, a 36 percent increase from the 320,422 who participated in 2011. Approximately 36 percent of the 1,201,363 professionals who were eligible to participate in 2012 participated in PQRS. The 2012 PQRS incentive payments totaled $167,815,193.
• PQRS participation is highest among eligible professionals who see the most Medicare patients.
  Eligible professionals who treat more Medicare beneficiaries have higher participation rates. While the overall PQRS participation rate is 36%, participation is at 53% among those who treat more than 200 Medicare beneficiaries a year, indicating the program’s specific success with the key subset of eligible professionals who are providing the most health care services to the Medicare population.
• Participation in the eRx program up by 22 percent from 2011.
  In 2012, 344,676 eligible professionals participated in the eRx program, a 22 percent increase from the 282,382 who participated in 2011. Approximately 44 percent of the 778,904 professionals who were eligible to participate in 2012 participated in the eRx program. The 2012 eRx incentive payments totaled $335,331,216.

The report demonstrates that one significant factor in the increased participation in these programs is CMS’s efforts to align quality measurement across programs in order to minimize the burden on eligible professionals participating in multiple programs.

“Aligning measures across quality programs focuses providers on the most important measures for patients and makes it easier to participate in programs like PQRS, which are designed to emphasize quality for Medicare beneficiaries,” said Dr. Conway.

Next years’ experience report will include the results of the final eRx program year, and CMS looks forward to reporting even stronger participation results.

More information about the PQRS, including how eligible professionals can participate and the criteria for reporting to qualify for an incentive payment, is available at http://www.cms.gov/PQRS.

More information about the eRx Incentive Program can be found at http://www.cms.gov/ERxIncentive/.

###