Medicare Quality Reporting Initiative PQRI Pays Over $36 Million To Participating Physicians From The 2007 PQRI Reporting Period

The PQRI is a voluntary program and, in accordance with a law passed by Congress late in 2006, physicians and other eligible professionals are able to receive bonus payments of 1.5 percent of their total allowed Medicare charges, subject to a cap, by satisfactorily submitting quality information for services they furnish between July and December of 2007. More than 109,000 professionals participated in the 2007. Physicians, physician group practices, and other PQRI eligible professionals should receive their payments by August 2008. The average incentive amount for individual professionals is over $600 and average incentive payment for a physician group practice is over $4,700.

While the 2007 PQRI was a positive step towards reporting quality information, the 2008 PQRI program included significant enhancements in terms of the scope of measures that could be reported, the opportunity to receive incentive payments for the entire year, ability to report measures within a group for a specified number of patients, and the use of registries to report quality measures.The 2008 PQRI program has grown to include 119 quality measures which were published in the Physician Fee Schedule for 2008.

As an alternative to submitting 2008 PQRI quality data as part of their Medicare claims submissions, eligible professionals may choose to report data on quality measures through a medical registry, and these registries will then report that data to CMS. Registry-based reporting will provide another way for eligible professionals to qualify for an incentive payment. Participating eligible professionals who dont report through a registry may choose to report data on either individual measures or on groups of measures that capture a number of data elements about common care processes for diabetes, kidney disease and preventive medicine. Registry-based reporting and reporting on groups of measures will provide more ways for eligible professionals to quality for an incentive payment.

More information about the PQRI program, including how eligible professionals can participate and the criteria to qualify for an incentive payment is available at here.