$36 Million Paid to Physicians in PQRI: 16 Percent of Radiologists Eligible for the Program Take Part
On July 15, the Centers for Medicare & Medicaid Services (CMS) announced payment of more than $36 million in bonus payments to many of the more than 56,700 health professionals who satisfactorily reported quality information to Medicare under the 2007 Physician Quality Reporting Initiative (PQRI). Physicians, physician group practices, and other PQRI eligible professionals should receive their payments by August 2008. The average incentive amount for individual professionals is more than $600, and average incentive payment for a physician group practice is more than $4,700, with the largest payment to a physician group practice totaling more than $205,700.
All eligible professionals that participated in the 2007 PQRI can begin accessing confidential feedback reports that aggregates the data they submitted and shows them how they compare with other participants. Providers must register with the Individuals Authorized Access to CMS Computer Services – Provider Community (IACS-PC) to access the feedback reports (please see access information below).
More than 109,000 professionals participated in the 2007 PQRI. Of those, more than 56,700 physicians and other eligible professionals met statutory requirements for satisfactory reporting for the 2007 reporting period and are receiving incentive payments. The 2007 reporting period received participation in all 50 states, including D.C., Puerto Rico, the Virgin Islands and Guam. Of all the participating states and territories, health professionals in Florida and Illinois are receiving the highest incentive payments for the 2007 reporting period. In Florida, they will receive a total of more than $3 million and in Illinois, a total of more than $2 million.
Based on data provided by CMS in late February 2008, an estimated 17 percent of clinicians that could participate in PQRI reporting did so. Preliminary data from February indicated that radiologists participated at approximately the same rate (on the two diagnostic radiology/stroke measures included in the program) — about 16 percent.
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.
The 2008 PQRI program has grown to include 119 quality measures which were published in the Physician Fee Schedule for 2008. Leading physician organizations participated in the development of the PQRI program measures. Nearly all of the measures are clinical performance measures, such as the percentage of patients who received necessary mammograms and cancer screenings. There are also two structural measures that focus on the use of electronic health records and electronic prescribing technology. The program is authorized to continue through 2009 and 2010, with the incentive payment for those years expected to increase from 1.5 to 2 percent, with no cap applied. Three new measures for diagnostic radiology that were developed by the ACR in conjunction with the AMA Physician Consortium for Performance Improvement may be included in 2009.
More information about the PQRI program, including how eligible professionals can participate and the criteria to qualify for an incentive payment is available on the CMS Web site. You may also contact the ACR for more specific information as it relates to radiology at P4Pquestions@acr.org.
Accessing Feedback Reports from the PQRI Portal
2007 PQRI feedback reports will be available through a PQRI Portal on a secured website, My QualityNet, as an Adobe® Acrobat® PDF in July 2008.
Click here to visit the home page of the PQRI Portal.
Directly under the login boxes you will see the text, “If you do not have an account, please register. Click on the word “register”, highlighted in blue, to be routed to the online Individuals Authorized Access to CMS Computer Services (IACS) application for a new user ID or click here to go directly to the link for this authorization.
Your browser will automatically route to https://idm.cms.hhs.gov/idm/user/newregistration.jsp. Select “Provider/Supplier Community” and follow prompts to register for your new IACS User Name. See IACS documentation at http://www.cms.hhs.gov/MMAHelp/07_IACS.asp.
If you do not have this IACS account, you must apply for a new account to be able to access the PQRI Portal and retrieve the feedback reports. An eligible professional within a TIN organization will be able to access the PQRI Portal immediately after applying online. Solo practitioners not submitting claims under a TIN organization will need to be validated further before access is granted to the PQRI Portal. PQRI does not control and cannot expedite IACS registration.
For questions on how to register, access, or change your IACS account, please contact External User Service (EUS) at 866-484-8049. For questions on the 2007 PQRI reports related to the quality measures listed or any discrepancies with the reports, please contact the QualityNet Help Desk at 866-288-8912 or qnetsupport@ifmc.sdps.org
If you have completed IACS vetting for a PQRI role and the TIN has a report, an e-mail will be sent to you alerting you to the report’s availability. The PQRI Portal via QualityNet is the secured entry point to access the reports. Your report is safely stored online and accessible only to you (and those you specifically authorize) through the IACS web application.
Additional links:
MLN articles with additional IACS information can be found on the CMS website at:
· http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0747.pdf – first article in this series provides an overview of the IACS-Provider Community (IACS-PC) registration process as well as registration instructions for Security Officials (SOs) and individual practitioners
· http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0753.pdf – second article addresses questions and gives remaining instructions for registering provider organizations including registering as a Backup Security Official (BSO), User Group Administrator (UGA), and End User (EU). It also discusses approving user requests.
· http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0754.pdf – third article discussing the final steps in accessing CMS enterprise applications has been released on this issue
