Although participation in the CMS’s physician-quality reporting system (PQRS) has increased, according to a recent CMS report, a large percentage of physicians still prefer to take a penalty rather than participate.
The 2013 report reflects the most recent participation statistics for the PQRS program and the final year of the electronic-prescribing incentive program. PQRS participation was up 47 percent in 2013 compared with the previous year, with approximately 51 percent of the 1.25 million professionals who were eligible participating in 2013. PQRS incentive payments for 2013 totaled $214.6 million.
Based on the 2013 PQRS reporting data, nearly 470,000 eligible professionals are subject to a 1.5 percent reduction in their 2015 Medicare Part B payments. Of that group, 98 percent chose not to participate in the PQRS program, and 43 percent treat 25 or fewer Medicare beneficiaries per year. This is the first year the negative payment adjustments are being implemented, as required by the Affordable Care Act.
By comparison, participation in the e-prescribing program increased just 9 percent between 2012 and 2013, with 46.6 percent of eligible professionals participating in the final year of reporting. The 2013 incentive payments for that program totaled $168.3 million.
The Merit-based Incentive Payment System created under the new SGR Repeal and Medicare Provider Payment Modernization Act will consolidate the PQRS, the Value-Based Modifier and meaningful use of EHRs (which incorporates e-prescribing) into one incentive program.