CMS Responds to AAFP Concerns, Modifies Analytical Process for PQRI

In response to concerns raised by the AAFP and other physician organizations during a December meeting, CMS has modified its analytical process for the Physician Quality Reporting Initiative, or PQRI, for 2007. It now plans to rerun data for the 2007 reporting period based on the revised analytical process to more accurately determine who successfully submitted a quality code and should be paid a bonus under the terms of the program.

In a Dec. 30 letter to AAFP Board Chair Jim King, M.D., of Selmer, Tenn., outgoing CMS Acting Administrator Kerry Weems said the agency has "uncovered certain technical issues related to the business rules for reporting."

"These can be dealt with through modifications to our analytic algorithms for calculating satisfactory reporting that will result in additional quality data codes being considered valid," said Weems.

In the meantime, the agency also has made changes to the PQRI algorithms for 2008 and has seen an increase in the number of physicians who qualified for the program in 2008 compared with 2007, said Bruce Bagley, M.D., the AAFP's medical director of quality improvement.

"Because of the time required to implement the new analytic algorithms, the payment for the 2008 PQRI is anticipated to be pushed out to late October or early November 2009," Weems said. "The additional 2007 PQRI payments will be made at the same time."

In addition, Weems noted that CMS expects "to publish, in early 2009, detailed, aggregate-level measures data information for claims-based reporting that occurred for the 2008 PQRI reporting year."

"As the information becomes available from our quarterly management reports throughout 2009 for the 2009 reporting year, we will share aggregate-level measures information submitted through the claims-based process," he said.