Reimbursement: MGMA blasts Medicare quality reporting project

October 10, 2008

The Medical Group Management Association criticized a Medicare quality reporting initiative, complaining that the program doesn't provide guidance on how to improve patient outcomes and creates an administrative burden on practices.

The Medical Group Management Association criticized a Medicare quality reporting initiative, complaining that the program doesn’t provide guidance on how to improve patient outcomes and creates an administrative burden on practices.

MGMA detailed its criticism of the Physicians Quality Reporting Initiative after it surveyed its members about their experiences with the program. In 2007, the Centers for Medicare & Medicaid Services launched the PQRI, a voluntary program in which participating physicians receive up to a 1.5 percent bonus to their total Medicare charges in exchange for sending quality data to CMS that could be used to overhaul how the agency pays physicians for their services.

Of the survey’s respondents able to obtain their PQRI reports from CMS, nearly 70 percent reported “low” or “no” satisfaction with the document’s guidance in improving patient outcomes. Nearly 93 percent reported difficulty in accessing their reports, according to the MGMA.

“While MGMA and its members support initiatives that help physicians provide high-quality patient care, these data highlight the fundamental problems with this program,” says William Jessee, MD, the group’s CEO.

On average, respondents to the survey spent five hours downloading their final 2007 PQRI feedback reports from CMS’ website. Sixty-three percent reported difficulty capturing and submitting data, the MGMA says.

“To truly improve patient care, programs such as PQRI must provide timely, actionable clinical information to physicians,” Jessee says. “Our data show the program has penalized practices trying to do the right thing for their patients by wrapping them in red tape.”

A CMS official declined comment on the specifics of MGMA’s survey results, but said CMS “pays close attention” to the feedback it receives on the PQRI. CMS is working on improving access to physicians’ PQRI reports, the official says.