Medicare Pay for Performance Program

On Tuesday, CMS released information on its Physician Quality Reporting Initiative (PQRI). PQRI offers Medicare participating physicians a 1.5% bonus on the Medicare fee schedule for participating in the quality improvement study beginning July 1, 2007. There are 74 PQRI measures. Many of the measures relate to elderly patients, the principal Medicare population, but several of them apply to younger patients and even children. PQRI is required by the Tax Relief and Health Care Act of 2006.

HIT reports that “At a webinar last December, Thomas B. Valuck, MD, a CMS medical officer and senior advisor said CMS is searching for the “sweet spot” that might entice more doctors to participate in P4P. ‘CMS is currently analyzing what the ultimate amount would be to engage the majority of physicians in voluntary participation,” Valuck said. ‘The 1.5 percent incentive is just a start. It could take as much as 20 percent to motivate physicians.’”