Although more than 1 million clinicians were considered eligible for Medicare's Physician Quality Reporting System (PQRS) in 2009, a mere 210,000 participated in the voluntary incentive program, according to an April 19 report from the Centers for Medicare & Medicaid Services (CMS). Among those who did submit data, nearly half--about 90,000-failed to earn bonus money.

And while the average payout was about $2,000 per provider who did successfully report PQRS data, physicians who spoke with American Medical News reported that much of their bonus money got eaten up by the costs of reporting the data.

For example, after billing errors kept New York internist Jef Sneider, MD, from earning a bonus three years in a row, he began using a registry service to send quality codes to Medicare for the rest of 2010. Although he says the investment helped improve his recordkeeping and tracking of diabetic patients, the service cost $275 to yield an expected bonus payment of just $600.

For Emergency Medicine Physicians in Canton, Ohio, participation in the program has been more successful, with the group of 750 emergency medicine physicians earning payouts of $704,089 in 2009, up from $112,798 in 2007 and $520,227 in 2008. The group owns a medical billing company that helps offset the costs of reporting. Although the bonuses remained lower than expected, the group's chief medical officer, Kevin Klauer, DO, said the effort was more about avoiding penalties than earning bonuses.

Starting in 2015, total Medicare pay will be reduced by 1.5 percent for physicians who fail to report quality codes satisfactorily. The penalty rises to 2 percent in 2016 and beyond.

Despite the frustrations physicians have voiced about the difficulty of participating in the program, which now includes 194 measures from which doctors can choose to report, CMS officials said they have seen gains in clinical quality in the first three years of the program.

To learn more:
- read the article from American Medical News

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