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Medical Practice Leaders Frustrated About Medicare's PQRI Data Requirements

Joe Cantlupe, for HealthLeaders Media, February 18, 2010

A national organization representing medical practice leaders say they are increasingly frustrated by what it terms the "unnecessarily arduous process" for reporting data to Medicare's Physician Quality Reporting Initiative (PQRI). Once the reports are filed, there is an "unreasonable lag time" for results, the group states.

The Medical Group Management Association (MGMA), which includes more than 22,000 members, who are professional administrators and leaders of medical group practices, on Wednesday released a sharply critical research survey about PQRI at a time Congress is considering how to continue the program. A bill proposed in the Senate imposes penalties on physicians who fail to participate in the PQRI, but the House bill does not. The program is currently voluntary.

The medical practice leaders cited "multiple, continued administrative challenges" in reporting data for the PQRI. The organization stated in its survey "respondents took issue with the unnecessarily arduous process for accessing feedback reports and expressed little to no satisfaction with feedback reports."

The PQRI was established under the 2006 Tax Relief and Health Care Act (TRHCA) to provide an incentive payment for eligible professionals, who satisfactorily report data on quality measures for professional services furnished to Medicare beneficiaries. In 2009, physicians could earn a PQRI incentive payment equal to 2% of their billed Medicare charges. In 2007, a much lower payout was reported, with $630 the average amount, according to the American Medical Association.

"Though MGMA and its members remain committed to supporting clinical quality improvement initiatives, data from this research shines a bright spotlight on the underlying administrative difficulties with this program," said MGMA President and CEO William F. Jessee, MD, in a statement.

Of survey respondents who attempted to participate in the 2008 PQRI, fewer than half—48%—were able to successfully access their PQRI feedback report, a decline from 2007 when 51% were able to retrieve their 2007 report, the MGMA stated.

As officials of the MGMA see it, the PQRI is so complicated it takes almost nine hours on average for physicians or their staff to successfully download the 2008 PQRI feedback reports.

"It's a very onerous report for some, and we have some very sophisticated members, " says Robert Bennett, government affairs specialist for the MGMA, referring to the PQRI program. "We're not against PQRI, we want to improve patient outcomes. But it has to be something that doesn't take hours to download; you don't want a physician's office spending hours everyday trying to figure out how to put in tax ID numbers into a database."

According to MGMA officials, in 2009, only an estimated 32% of physicians even attempted to log into the program, while a mere 16% succeeded. "You have physicians who want that gold standard, [the PQRI], it's good for marketing, but it takes up to six months to get a response from the [Centers for Medicare and Medicaid Services]," Bennett says.

The survey also found:

  • 60% of medical practices assessed their 2008 feedback reports and were "dissatisfied or very dissatisfied" with the report's presentation of information.
  • 67% were dissatisfied or very dissatisfied with the 2008 PQRI reports' effectiveness in providing guidance to improve patient care outcomes.
  • While it took five hours "on average collectively" for medical practices to access their 2007 PQRI feedback reports, it took almost nine hours by practice staff and physicians to download the 2008 PQRI feedback reports.

Even if physicians get into the PQRI, there's still a question of being eligible for bonuses. About 109,000 physicians who reported their data nationwide in 2007, only slightly more than half qualified for bonus payments, according to an American Medical Association study.

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