CMS awards $662 million for eRx, quality reporting

April 4, 2012

CMS awarded more than half a billion dollars to successful e-prescribers and participants in its PQRS program. When you average it out, however, it's not as much as you?d think.

Physicians earned more than $662 million in 2010 for successfully participating in the Centers for Medicare and Medicaid Services (CMS) e-prescribing and Physician Quality Reporting System (PQRS), according to a report released by the agency.

March 30, CMS released “2010 Physician Quality Reporting System and eRx Experience Report,” which showed an increase in participation and incentives awarded. In 2010, 269,000 eligible professionals participated as individuals and part of group practices in the PQRS program compared with 211,000 in 2009 and 154,000 in 2008. PQRS incentive payments in 2010 totaled $391 million compared with $236 million earned in 2009 and $95 million earned in 2008.

Nearly 131,000 eligible professionals participated in the e-prescribing program in 2010, compared with 90,000 in the 2009. Incentive payments in 2010 totaled $270 million compared with $148 million in 2009.

The average incentive amount for professionals who satisfactorily reported in the PQRS was less than $2,000 in 2010 and more than $3,000 for successful electronic prescribers.

Much of the data reported through the PQRS represent clinical performance measures (for example, percent of age-appropriate women receiving mammograms to screen for breast cancer) that were developed by organizations such as the American Medical Association and the National Committee for Quality Assurance.

Legislation extended incentive payments for the PQRS through 2014. Beginning in 2015, eligible professionals who do not report data to CMS satisfactorily in the PQRS will receive a payment cut of 1.5%. In 2016 and subsequent years, the reduction will increase to 2%. Physicians who did not successfully e-prescribe by June 2011 already face a 1% penalty on their 2012 Medicare payments. They have until June 30 of this year to avoid a 1.5% cut in their 2013 payments.

More information about the PQRS, including how eligible professionals can participate and the criteria for reporting to qualify for an incentive payment, is available at http://www.cms.gov/PQRS. For the e-prescribing incentive program, visit www.cms.gov/ERxIncentive.

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