PQRI Changes Offer Physicians More Reporting Options

CMS recently announced tweaks to its 2008 Physician Quality Reporting Initiative, or PQRI, that should make it easier for family physicians and other eligible health care professionals to participate in -- and benefit from -- the program this year.

CMS has given PQRI participants more flexibility in how they submit quality measurement data. For example, eligible providers can continue to report data as part of their Medicare claims submissions process, or they can collect and report PQRI quality measures through a patient registry. The registry then would send the data to CMS.

Another new option allows PQRI participants to report data on groups of measures -- as opposed to reporting on individual measures -- thus allowing capture of data elements about common care processes for diabetes, kidney disease and preventive medicine.

According to a CMS press release, eligible professionals who submit data in measures groups "may now start reporting in July 2008 and still be eligible to earn an incentive payment for the 2008 PQRI program."

Congressional action late in 2007 (i.e., passage of the Medicare, Medicaid and State Children's Health Insurance Program, or SCHIP, Extension Act of 2007) required HHS to establish alternative PQRI criteria and reporting periods for the 2008 program.

"By providing more opportunities to submit information about the quality of care provided to Medicare beneficiaries, we will ultimately improve the services provided to our beneficiaries," said CMS Acting Administrator Kerry Weems in the press release.

Weems also made it clear that CMS was pleased with PQRI participation rates in 2007. "We are encouraged by the success of the program so far, and with the new options for data reporting, more health professionals should take advantage of the reporting program," he said.

In March, CMS reported that 15.74 percent of all professionals eligible to participate in the 2007 PQRI program attempted to do so; 92,218 individuals submitted at least one measure successfully.