PQRS and eRx Programs Pay Off for Participating Providers

A report released by the Centers for Medicare & Medicaid Services (CMS) April 19 shows a growing trend toward physicians and other eligible professionals (EPs) participating in the Physician Quality Reporting System (PQRS) and the Electronic Prescribing (eRx) Incentive Program. Both programs reward physicians and other EPs for successfully reporting quality measures with a percentage of their estimated Part B Medicare Physician Fee Schedule (MPFS) allowed charges for covered professional services.According to the CMS report “2009 Physician Quality Reporting System and eRx Experience and Trends,” 119,804 physicians and other EPs in 12,647 practices satisfactorily reported data on quality measures. As a result, CMS paid over $234 million in PQRS incentive payments in 2009, compared to $36 million in 2007—the first year of the program. CMS additionally paid $148 million to 48,354 successful ePrescribers in 2009—the first payment year of the eRx program.

CMS Administrator Donald Berwick, MD, said, “The significant growth in the Physician Quality Reporting System shows us that the health care community shares CMS’s commitment to improving the quality and safety of care our beneficiaries receive.”

On average, satisfactory PQRS reporters earned bonus payments in 2009 totaling $1,956 per provider and $18,525 per practice. Successful electronic prescribers in 2009 earned average bonus payments just over $3,000 per provider and $14,501 per practice.

Currently, only about one in five health care professionals who can participate in the PQRS do so. Although participation in both programs is optional, providers who are able to participate in these programs but choose not to will receive payment reductions from Medicare in the coming years.

Visit the CMS website to learn more about the PQRS and eRx programs. To read the 2009 “Physician Quality Reporting System and eRx Experience and Trends” report, click on the appropriate link in the Downloads section on either the PQRS or eRx web page.

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