Participation in two key CMS programs, the Medicare Physician Quality Reporting System (PQRS) and the Electronic Prescribing Incentive Program (eRx), increased significantly in 2012, according to the 2012 Physician Quality Reporting System and Electronic Prescribing (eRx) Experience Report.
These two key programs enable eligible professionals to earn incentive payments through voluntary participation, officials state. Over 430,000 professionals participated in the eRx program, and more than 340,000 used e-prescribing.
PQRS will begin to use payment adjustments in 2015, to encourage eligible healthcare professionals to report on designated quality measures. The eRx Incentive Program used a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals.
Key findings from the report include the following:
- 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.
- While the overall PQRS participation rate is 36 percent, participation is 53 percent 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 healthcare 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.
Source: CMS, April 3, 2014
Guide to Physician Performance-Based Reimbursement: Payoffs from Incentives, Data Sharing and Clinical Integration explores newly minted reimbursement formulas at two health plans and two independent practice associations (IPAs), providing payor and provider perspectives on the formula development process; clinical, quality and efficiency measures in use; physician incentive payments and program outcomes.