American Academy of Family Physicians

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PQRI Cash Bonuses Await Physicians in 2008

New Measures Added, Timeline Expanded

By Sheri Porter

Funding for CMS' 2008 Physician Quality Reporting Initiative, or PQRI, was confirmed recently in an e-mail from CMS to AAFP and other medical specialty societies. The e-mail assured physicians that they could qualify for the same 1.5 percent bonus payments in 2008 that were available to them in 2007.

Business of Medicine
However, time is not on the side of undecided physicians sitting on the sidelines, said Bruce Bagley, M.D., AAFP's medical director of quality improvement. The clock for the 2008 reporting period already has begun ticking.

Physicians could earn 2008 PQRI bonus payments by reporting on three PQRI measures 80 percent of the time for fee-for-service Medicare patients who are eligible for those measures. The reporting period runs from Jan. 1 to Dec. 31, 2008, hence Bagley's sense of urgency. "Physicians need to get on board and do it quickly, because if they wait until February or March they simply won't have enough months left in 2008 to reach that 80 percent threshold," he said.

Bagley pointed out that, compared with last year, physicians have the opportunity to double their PQRI bonus money in 2008 because the PQRI reporting period covers a full 12 months, versus just six months in 2007.

Physicians can estimate their possible bonus earnings for 2008 by multiplying their total Medicare practice revenue for 2007 by 1.5 percent. According to Bagley, physicians could earn $800 or more in bonus money this year.

It's Easy to Start!

There's no need to register or enroll to participate in CMS' Physician Quality Reporting Initiative, or PQRI; you simply choose the quality measures you plan to use and start reporting the appropriate quality measurement data on claims you submit to your Medicare claims processing contractor.

CMS has posted a complete list of those measures and their accompanying specifications online (337-page PDF; About PDFs), and Bruce Bagley, M.D., AAFP's medical director of quality improvement, advises familiarizing yourself with those choices up front and choosing wisely. (Read a Family Practice Management article Bagley wrote last year on this topic.) You will, he notes, need to include your National Provider Identifier number on those claims.
In addition to a longer reporting period, nearly 50 new quality measures have been added to the PQRI, although relatively few of them are of value to family physicians. Bagley said two new measures pertaining to electronic health records, or EHRs, and electronic prescribing would be of particular interest to FPs who already have EHRs up and running. A list of the 119 measures for 2008 and related materials, along with other information about participating in PQRI, is available on the CMS Web site.

Bagley said he anticipated an increase in physician PQRI participation in 2008. And although a little extra cash is nice, Bagley acknowledged, he encouraged FPs to recognize other benefits of the program, including the opportunity to
  • ensure delivery of consistent and high-quality patient care,
  • train staff in quality improvement efforts, and
  • gather experience in the collection and reporting of quality improvement data that will prepare practices for future pay-for-performance opportunities and dollars.

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