Published on March 28, 2014
By Teri Yates
On November 27, 2013, the Centers for Medicare and Medicaid Services (CMS) finalized a number of changes to the Physician Quality Reporting System (PQRS). PQRS is one of several pay-for-performance models devised and implemented in recent years to facilitate the collection of quality information about the care provided to Medicare beneficiaries by physicians and other eligible professionals (EPs).
The earliest version of PQRS, known at the time as the Physician Quality Reporting Initiative, was first implemented in 2007 as a voluntary program that offered incentive payments in exchange for reporting. Participation in the program was low at first despite the significant bonus payments offered, with physicians citing several reasons, including confusing program guidance from CMS, low confidence that the program actually improved quality, and limited success at actually achieving the bonus payments when reporting was attempted. Many of the physicians who did earn incentive payments early in the program concluded the costs outweighed the benefits of participating; those frustrating experiences did little to encourage expansion among other EPs. Despite its inauspicious start, continuation of the PQRS program was assured in 2010 by the Patient Protection and Affordable Care Act, and over time the program has been modified to incorporate both incentives and payment penalties to promote reporting.