CMS: eRx, PQRS use climbing in recent years

A total of $662 million in incentives were paid in total for both the Physician Quality Reporting and e-Prescribing (eRx) Incentive Programs, according to a conference call hosted by the Centers for Medicare & Medicaid Services (CMS) June 19. The amount represents a 72 percent increase over 2009.

Over 64,000 individual eligible professionals and almost 13,000 practices participated in both programs in 2010. “Fifty-two of those individual eligible professionals participating in both programs were incentive eligible in both programs,” noted slides from the presentation provided by CMS.

Broken down, 244,145 participated in the Physician Quality Reporting System (PQRS) in 2010, an increase from 100,000 in 2007 where 168,843 individual eligible professionals, representing 19,232 practices, earned incentive payments totaling $391 million. Total incentive payments increased 65 percent from 2009 and the number of practices qualified for incentive increased 50 percent from 2009.

Participation rate increased 15 to 24 percent from 2007-2010, the presentation slides noted. In 2010, average incentive amount for an individual eligible professional was $2,157, up from $1,962 in 2009. For a practice, the average incentive payment in 2010 was $20,364, up from $18,519 in 2009.

In the eRx program, there were 113,074 participants in 2010 where 65,857 individual eligible professionals and 18,713 practices earned incentive payments totaling $270.8 million. “Total incentive payments increased 83 percent from 2009 ($148 million), the slides noted. The average incentive amount in 2010 was $3,836 per eligible professional and $14,476 per practice.

Registry reporting increased from 2008 to 2010, CMS noted, where 31 qualified registries in 2008 shot up to 89 qualified registries submitted data for participating professionals in 2010; approximately 90 percent earned an incentive. Individual measures of PRQS measures has jumped from 153 in 2009 to 198 in 2011.

The most commonly reported measured groups were preventive care and diabetes, CMS noted. However, some specialties participated more frequently in 2010 than others:

  • Emergency medicine physicians, family practitioners, internists and anesthesiologists had the largest number of participants in PQRS;
  • Internists and family practitioners were the most frequent participants using claims-based measures groups and registry submission methods; and
  • Internists and family practitioners also were common eRx incentive program participants, but cardiologists and ophthalmologists had the highest participation rates.

The number of eligible professionals participating individually increased 16 percent and 26 percent, respectively, from 2009 PQRS and eRx Incentive Program, the slide stated, adding preliminary counts for 2011 eRx Incentive Program increased 42 percent among eligible professionals who participated individually.

The presentation concluded that 2012 is the last year to report for only the incentive payment. “Future years will utilize reported measure data to determine incentive and payment adjustment eligibility,” the slides stated, where applicable payment adjustment amounts are:

  • 2015: 1.5 percent (based on the 2013 reporting period)
  • 2016 and each subsequent year: 2 percent.

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