Although a growing number of physicians are earning federal payments for reporting quality measures or writing electronic prescriptions, nearly three-quarters of eligible physicians still aren’t taking part in the incentive programs, according to the Centers for Medicare and Medicaid Services.
In 2010, about 269,000 eligible health care professionals participated in the Physician Quality Reporting System (PQRS, formerly known as the Physician Quality Reporting Incentive program), up from 210,000 in 2009 and 153,000 in 2008. That means that 26% of the 1 million eligible professionals participated in 2010, according to CMS payment and reporting data for that year, as well as data from the Electronic Prescribing Incentive Program.
Physicians’ use of registries to report data also increased. In 2010, there were 89 CMS-qualified registries submitting data from 56,000 eligible professionals. Ninety percent of those using a registry received an incentive payment.
The agency paid out $391.6 million in incentives in 2010 for the PQRS. Eligible professionals were able to earn 2% of the CMS’s estimate for allowed charged under Medicare Part B during the reporting period.
Close to 131,000 of the 696,000 eligible professionals participated in the eRx incentive program in 2010, receiving about $271 million. In 2009, only 89,000 participated. As with PQRS, the incentive was equal to 2% of the estimate of allowed charges for service during the reporting period.
Under the PQRS program, the most frequently reported measures included performance of an electrocardiogram in the emergency department; adoption or use of electronic health records; and giving timely and appropriate antibiotics before surgery.
There were big boosts in performance for a number of measures. About 93% of physicians screened diabetics for eye-related complications and then reported it to the patients’ endocrinologist, up from 70% in 2007. Almost 100% of patients with chronic obstructive pulmonary disease were given prescriptions for bronchodilators, up from 78% in 2007.
Although the measures are supposed to make it possible for a broad range of specialties to participate, a large number of measures apply to emergency medicine and family practice. Not surprisingly, emergency physicians had the highest rate of participation, with 65%, or 32,030 of the 49,278 who were eligible, reporting on at least one measure. Almost half of anesthesiologists participated; while 16% of family physicians who were eligible participated (14,778 of 91,533). Internal medicine physicians were close behind, with just over 15% (14,427 of 92,424) participating.
Family medicine and internal medicine specialists were among the largest numbers who participated in a registry to submit data, followed by cardiologists.
Cardiologists had the highest rates and highest numbers of participants in e-prescribing. A total of 35%, or 7,994 of the 22,606 eligible cardiologists, successfully reported on at least 25 unique prescribing events. A total of 26% of family practice physicians and 24% of internists participated, making them the top specialty participants by numbers. But ophthalmology, rheumatology, and urology had higher rates of participation for their specialties.
Beginning in 2015, CMS will cut physician pay by 1.5% for those who do not satisfactorily report data under the PQRS. From 2016 on, payments will be cut by 2%.
The "downward adjustment" is already in effect this year for the e-prescribing program. Professionals who did not meet criteria will have a 1% pay cut in 2012 and a 1.5% cut in 2013. Some, however, will be exempt from the pay cut. More information on becoming exempt is available here.