Medicare Physician Quality
Reporting, Use of Electronic Prescribing Show Increases
New report issued today compares
participation in 2011 and 2012
April 3, 2014 – Two key programs
aimed at improving service to seniors and the disabled in Medicare have
shown significant increases, according to the Centers for Medicare &
Medicaid Services (CMS). This report, however, just includes data on the
increase from 2011 to 2012 in the systems – the Physician Quality
Reporting System and Electronic Prescribing (eRx).
The 2012 report found that there
was increased participation in both PQRS and the eRx Program, marking
progress in CMS’s efforts to improve quality measurement, as well as to
build a national electronic health information infrastructure in the
United States. Both programs allow eligible professionals to earn
incentive payments through voluntary participation.
Report highlights include:
Participation in the PQRS
program increased by 36 percent from 2011.
In 2012, 435,931 eligible
professionals participated as individuals and as part of group practices
in PQRS, through at least one reporting method, a 36 percent increase
from the 320,422 who participated in 2011. Approximately 36 percent of
the 1,201,363 professionals who were eligible to participate in 2012
participated in PQRS. The 2012 PQRS incentive payments totaled
Majority of physicians said they were
alerted to a potential medication error or critical lab value by an
electronic health record; one-third say they help spot needed tests;
Medicare offers physicians incentive
PQRS participation is
highest among eligible professionals who see the most Medicare patients.
Eligible professionals who treat
more Medicare beneficiaries have higher participation rates. While the
overall PQRS participation rate is 36%, participation is at 53% among
those who treat more than 200 Medicare beneficiaries a year, indicating
the program’s specific success with the key subset of eligible
professionals who are providing the most health care services to the
Participation in the eRx
program up by 22 percent from 2011.
In 2012, 344,676 eligible
professionals participated in the eRx program, a 22 percent increase
from the 282,382 who participated in 2011. Approximately 44 percent of
the 778,904 professionals who were eligible to participate in 2012
participated in the eRx program. The 2012 eRx incentive payments totaled
“Our physician and other clinician
quality programs reached new records this year with over 430,000
professionals participating in the Physician Quality Reporting System
and over 340,000 e-prescribing,” said Patrick Conway, M.D. deputy
Administrator for innovation and quality and chief medical officer at
“Clinicians are actively measuring
and reporting on quality, and CMS is in the beginning stages of adding
this information to the Physician Compare website, which can be viewed
by patients. Measuring, transparently sharing, and improving quality
performance is key to a better health system.”
The Physician Quality Reporting
System (PQRS) has been using incentive payments, and will begin to use
payment adjustments in 2015, to encourage eligible health care
professionals to report on designated quality measures. The Electronic
Prescribing (eRx) Incentive Program used a combination of incentive
payments and payment adjustments to encourage electronic prescribing by
The report demonstrates that one
significant factor in the increased participation in these programs is
CMS’s efforts to align quality measurement across programs in order to
minimize the burden on eligible professionals participating in multiple
programs, according to CMS.
“Aligning measures across quality
programs focuses providers on the most important measures for patients
and makes it easier to participate in programs like PQRS, which are
designed to emphasize quality for Medicare beneficiaries,” said Dr.
Next years’ experience report will
include the results of the final eRx program year, and CMS looks forward
to reporting even stronger participation results.
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