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Few Oncologists Participating in CMS’ PQRI
Congress established the Physician Quality Reporting Initiative (PQRI) in late 2006 to start a big push towards CMS paying for quality and efficiency of care as opposed to quantity of services provided in the current fee-for-service model. Participants who submit data as required by CMS can receive an incentive payment of 2% of total Medicare charges.
Enrolling in the program includes no registration forms. A provider simply starts “…reporting the measures through Medicare claims or one of the approved registries,” (Oncology Times, 5/25/10). As easy as that sounds, actually qualifying for the incentives is difficult, as nearly half of all providers’ submissions were rejected for 2008 data. As the above-referenced article notes, “The main reasons [for disqualification]: incorrect or insufficient data submission.”
In the oncology field, participation in PQRI has been very low. Of the few providers that have participated, even fewer actually receive the incentive payment. As a consequence, “The general feeling…is it’s a lot of work and it’s not meaningful work. It seemed like free money, so many of us have tried it by it has not worked out,” the article goes on to say. Patrick Cobb, MD, President of COA, suggests the issue is around the reporting items in PQRI. He feels that, “paying bonuses to oncologists who report whether they follow evidence-based guidelines for treatment planning and end-of-life care,” is more sensible than the current design. Other oncologists would rather see ASCO’s Quality Oncology Practice Initiative (QOPI) used over PQRI.
Whatever changes may-or-may-not be made, it is certain that practices will never qualify for the incentives if they never even try. For more details on PQRI and to learn how to participate, click here to follow a link to the Oncology Times article about it.