Why Should I Participate in PQRS?

 Physicians who participate in PQRS can find many advantages.

They include:

  • Improving the quality of care they provide
  • Increasing the payment they receive for services
  • Better preparation for future changes in the health care delivery system

PQRS can improve quality.

Physician Quality Reporting Systems (PQRS) provide an opportunity for practices to begin using objective, evidence-based guidelines to assess the quality of care they provide.

Ghassan Salman, MD, chief medical officer for Austin Diagnostic Clinic (ADC), says his group is in its fourth year of PQRS participation. They started small, with only about a dozen physicians reporting the first year. This year, 88 of the 120 ADC physicians will participate. ADC reports on diabetes care, mammograms, colonoscopy, heart disease, chronic kidney disease, and more.

He says the PQRS incentive payments may not cover all of the expenses ADC incurred in participating, which include staff time and other overhead costs in collecting the data, as well as distributing some of the bonus funds to ADC's physicians to encourage wider use of evidence-based medicine. But the group sees value in quality reporting.

"There is a concerted effort at ADC to stand behind our core values, which is quality care for all patients," Dr. Salman said. "And our board understands that this effort may not return all the money that we're investing in it, but they're supportive because that's how we differentiate ourselves, by putting the patient first."

If ADC retained all the financial rewards, the bonuses would cover its expenses, Dr. Salman says. "There is no doubt that the return on investment is good, and I encourage every clinic and physician to participate."

Dr. Salman says the amount of the PQRS bonuses that ADC passes on to its physicians is based on their performance. "This encourages evidence-based medicine and leads to improved patient care," he said. "The physicians have been responsive to the data that we give them," he added. "Some of the measures were not as good as the physicians would like them to be, partly because of documentation. So the physicians have become more aware of documentation."

PQRS can lead to more payment for servies.

Garland family physician Cliff Fullerton, MD, is among 129 physicians in the Health Texas Provider Network who recently received a total of $280,000 in bonus payments from Medicare for reporting quality data under PQRS in 2009.             

Dr. Fullerton says PQRS reporting involved a handful of diabetes-related measures.

"We were able to collect the data right out of our EHR [electronic health record] with really no work for the clinical staff," Dr. Fullerton said. "Physicians may have spent literally five minutes on their component of that reporting."

Reporting via a CMS-qualified registry takes paper-based practices an estimated hour to three hours.

PQRS can prepare physicians for the future.  

PQRS Payment Timeline
Visit www.cms.gov/PQRS for more information.