PQRI Payments Up, Headaches Remain

The Centers for Medicare and Medicaid Services has reported a large increase in incentives paid in 2008 to provider organizations through the Medicare Physician Quality Reporting Initiative. But reporting requirements still remain burdensome, as only 85,000 of 162,800 participating professionals–52%–met statutory requirements and received incentive payments.


The Centers for Medicare and Medicaid Services has reported a large increase in incentives paid in 2008 to provider organizations through the Medicare Physician Quality Reporting Initiative. But reporting requirements still remain burdensome, as only 85,000 of 162,800 participating professionals--52%--met statutory requirements and received incentive payments.

All total, Medicare paid out $92 million in PQRI incentive payments during 2008 for the reporting of data to measure the quality of care. That compares with $36 million in 2007 when eligible professionals could only participate during a 6-month reporting period. In 2008, the program expanded to permit reporting for either a 6-month or 12-month period. Reportable measures in 2008 increased to 119 from 74 a year earlier.

The PQRI incentive payment is 1.5% of the total estimated allowed charges under Medicare Part B for covered professional services. The average incentive amount for individual professionals was more than $1,000 with the largest payment totaling more than $98,000.

PQRI participants in 2008 for the first time had the choice to report data through one of 31 qualified medical registries. Nearly 8% of participants attempted to do so and 96% met the requirements for satisfactory reporting. These participants accounted for 17% of overall incentive payments during the year.

More information is available at cms.hhs.gov/PQRI.

--Joseph Goedert

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