Report Assesses Physician Experiences With PQRI

CMS has released a report that examines participation data from its 2007 Physicians Quality Reporting Initiative, or PQRI, and also addresses physicians' frustrations with the program.

In the report's executive summary, CMS says it is "committed to a successful PQRI program," and promises to "reduce or eliminate" the issues identified in the report, Physician Quality Reporting Initiative: 2007 Reporting Experience. (32-page PDF; About PDFs).

Earlier this month, AAFP Board Chair Jim King, M.D., of Selmer, Tenn., blasted CMS for its bungling of the distribution of PQRI bonus payments and told CMS Acting Administrator Kerry Weems that if problems weren't addressed, physicians might refuse to participate in the program.

According to the new CMS report, the agency paid eligible providers slightly more than $36 million in incentive payments for the 2007 PQRI reporting period. The average bonus paid to individual providers was $635. The average bonus paid to practice groups was $4,700.

Of the more than 14 million quality data codes submitted, 51.6 percent were submitted correctly; 48.4 percent of submissions were invalid.

CMS says that nearly 16 percent of all eligible providers and groups submitted at least one quality data code during the 2007 PQRI reporting period. Of those 109,359 providers or groups,

The CMS report also identifies possible causes for the more than 48 percent of invalid codes submitted. CMS says that based on its review, many physicians didn't adhere to quality measure reporting specifications. Some of the most common errors CMS found were incorrect

The National Provider Identifier, or NPI, number also created problems for physicians. More than 12 percent of submissions didn't include an NPI number on the appropriate line with the reported quality data. In addition, billing and clearinghouse errors involving NPI numbers invalidated some physicians' reports.

CMS acknowledges that the computerized system designed specifically to allow physicians access to their feedback reports created problems and that registration to the secure accounts were "both cumbersome and time consuming."

The agency also notes that the purpose of the reports -- which were required by the PQRI business rules -- was to provide information related to reporting and incentive money earned. The reports were never intended to give physicians quality improvement information, says CMS.

In response to complaints that the 2007 feedback reports were difficult to understand, CMS promises that the 2008 feedback reports will be redesigned to provide more helpful information to PQRI participants.

Physicians with questions about accessing their PQRI feedback reports should refer to updated articles in CMS' online publication MLN Matters.

With an eye to the future, CMS is offering an extensive educational plan to help physicians and other eligible providers easily obtain need-to-know information about the 2009 PQRI.

CMS pledges to offer tools such as

CMS also is seeking additional registries for submission of 2009 PQRI data.