Looking Back and Forward at PQRS and eRx Participation
The Centers for Medicare & Medicaid Services (CMS) released its annual experience report for the Physician Quality Reporting System (PQRS) and E-prescribing (eRx) earlier this year. A summary of some of the report’s highlights are described below. A copy of the full report is available at http://go.cms.gov/12ZSwil. PQRS in 2011 An estimated 320,422 eligible professionals participated in PQRS during 2011. Through successful participation in the 2011 PQRS program, physicians and other eligible professionals received a 1 percent incentive payment on their total estimated Part B Medicare Physician Fee Schedule (MPFS) allowed charges provided during the reporting period. Of those who participated, nearly 83 percent earned a 2011 incentive payment; the average incentive was $1,059 per individual eligible professional. Which Reporting Method was Most Successful? As with prior years, claims-based reporting was the least successful reporting method—only 64 percent of participants reporting measures groups were eligible for an incentive. For individual participants, registry and electronic health records (EHR) reporting had an average success rate of 90 percent. As a reminder, the AAO-HNS continues to make PQRIwizard, a CMS-certified registry product tailored to otolaryngology, available for PQRS reporting. More details about the reporting options and PQRIwizard are available at http://www.entnet.org/pqrs. How Did Otolaryngologists Fare? A record number of otolaryngologists (1,852) participated in the PQRS program during 2011, representing 21.4 percent of those eligible to participate. In total, otolaryngologists earned more than $1.7 million in incentive payments during 2011 with 77.6 percent of participating otolaryngologists earning an incentive. While the maximum incentive payment paid was $7,848, otolaryngologists earned an average incentive payment of $1,222. What Measures Were Reported? One of the most common questions regarding PQRS participation relates to which measures otolaryngologists report. In 2011, the top five measures reported within otolaryngology were: 124 – Health Information Technology (HIT): Adoption/Use of EHR* 130 – Documentation of Current Medications in the Medical Record 226 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 91 – Acute Otitis Externa (AOE): Topical Therapy 92 – Acute Otitis Externa (AOE): Pain Assessment* *Note: Measures 124 and 92 are not available for PQRS reporting in 2013 E-Prescribing in 2011 An estimated 282,382 eligible professionals participated in eRx during 2011, the vast majority (97 percent) participating via the claims-based reporting mechanism. A total of 38 percent of those eligible for the program participated in 2011, an increase from 16 percent in 2010. Professionals who successfully reported in the eRx program were eligible for a 1 percent incentive payment on their Part B MPFS services. Nearly 62 percent of program participants were eligible for an incentive payment in 2011. How Did Otolaryngologists Fare? Again, a record number of otolaryngologists participated in the eRx program during 2011. Almost 50 percent of otolaryngologists (4,142 individuals) eligible for the program participated, with 2,364 earning an incentive payment. In total, otolaryngology received more than $3.8 million in incentive payments in 2011 with the average payment within the specialty being $1,617 and a maximum incentive payment of $13,312. PQRS and eRx in 2013 CMS continues to emphasize the importance of participation in both the PQRS and eRx programs. This year is of particular importance as participation is now tied to future penalties (payment adjustments). The AAO-HNS has developed a variety of resources to help members and their practices participate in these programs. You may have noticed in recent editions of the Bulletin factsheets regarding these programs (May Bulletin) and a participation reporting timeline (June Bulletin). The AAO-HNS Health Policy and Quality staff members are happy to answer any questions you may have about these programs; they can be contacted at qualityimprovement@entnet.org. AAO-HNS resources related to PQRS and eRx are available at http://bit.ly/CMSQI.
The Centers for Medicare & Medicaid Services (CMS) released its annual experience report for the Physician Quality Reporting System (PQRS) and E-prescribing (eRx) earlier this year. A summary of some of the report’s highlights are described below. A copy of the full report is available at http://go.cms.gov/12ZSwil.
PQRS in 2011
An estimated 320,422 eligible professionals participated in PQRS during 2011. Through successful participation in the 2011 PQRS program, physicians and other eligible professionals received a 1 percent incentive payment on their total estimated Part B Medicare Physician Fee Schedule (MPFS) allowed charges provided during the reporting period. Of those who participated, nearly 83 percent earned a 2011 incentive payment; the average incentive was $1,059 per individual eligible professional.
Which Reporting Method was Most Successful?
As with prior years, claims-based reporting was the least successful reporting method—only 64 percent of participants reporting measures groups were eligible for an incentive. For individual participants, registry and electronic health records (EHR) reporting had an average success rate of 90 percent. As a reminder, the AAO-HNS continues to make PQRIwizard, a CMS-certified registry product tailored to otolaryngology, available for PQRS reporting. More details about the reporting options and PQRIwizard are available at http://www.entnet.org/pqrs.
How Did Otolaryngologists Fare?
A record number of otolaryngologists (1,852) participated in the PQRS program during 2011, representing 21.4 percent of those eligible to participate. In total, otolaryngologists earned more than $1.7 million in incentive payments during 2011 with 77.6 percent of participating otolaryngologists earning an incentive. While the maximum incentive payment paid was $7,848, otolaryngologists earned an average incentive payment of $1,222.
What Measures Were Reported?
One of the most common questions regarding PQRS participation relates to which measures otolaryngologists report. In 2011, the top five measures reported within otolaryngology were:
- 124 – Health Information Technology (HIT): Adoption/Use of EHR*
- 130 – Documentation of Current Medications in the Medical Record
- 226 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
- 91 – Acute Otitis Externa (AOE): Topical Therapy
- 92 – Acute Otitis Externa (AOE): Pain Assessment*
*Note: Measures 124 and 92 are not available for PQRS reporting in 2013
E-Prescribing in 2011
An estimated 282,382 eligible professionals participated in eRx during 2011, the vast majority (97 percent) participating via the claims-based reporting mechanism. A total of 38 percent of those eligible for the program participated in 2011, an increase from 16 percent in 2010. Professionals who successfully reported in the eRx program were eligible for a 1 percent incentive payment on their Part B MPFS services. Nearly 62 percent of program participants were eligible for an incentive payment in 2011.
How Did Otolaryngologists Fare?
Again, a record number of otolaryngologists participated in the eRx program during 2011. Almost 50 percent of otolaryngologists (4,142 individuals) eligible for the program participated, with 2,364 earning an incentive payment. In total, otolaryngology received more than $3.8 million in incentive payments in 2011 with the average payment within the specialty being $1,617 and a maximum incentive payment of $13,312.
PQRS and eRx in 2013
CMS continues to emphasize the importance of participation in both the PQRS and eRx programs. This year is of particular importance as participation is now tied to future penalties (payment adjustments).
The AAO-HNS has developed a variety of resources to help members and their practices participate in these programs. You may have noticed in recent editions of the Bulletin factsheets regarding these programs (May Bulletin) and a participation reporting timeline (June Bulletin). The AAO-HNS Health Policy and Quality staff members are happy to answer any questions you may have about these programs; they can be contacted at qualityimprovement@entnet.org.
AAO-HNS resources related to PQRS and eRx are available at http://bit.ly/CMSQI.
