Quality Reporting Incentive Payments Surge


A Centers for Medicare & Medicaid Services (CMS) report that shows a nearly 300% increase in bonus payments under Medicare's Physician Quality Reporting Initiative (PQRI) is further evidence that hospitalists are embracing pay-for-reporting measures, according to the chair of SHM's Performance and Standards Committee.

Patrick Torcson, MD, MMM, FACP, director of hospital medicine at St. Tammany Parish Hospital in Covington, La., says increased usage of pay incentives to push quality reform is "past that tipping point, but what's really unknown right now is what's going to happen with the healthcare reform in front of us right now."

"It's an evolution for physicians to accept that pay for performance, starting with pay for reporting, is here to stay," Dr. Torcson says. "It's really a matter of the practice management that's necessary to include performance reporting as part of the workflow of how you take care of patients and report your billing claims."

In 2008, CMS paid $92 million in bonuses under the PQRI program, an increase from $36 million in 2007. However, the program was only active for the second half of 2007, so Dr. Torcson cautions against reading too much into the increase. Still, CMS reported that payments were distributed to more than 85,500 physicians with an average payment of $1,000. In Dr. Torcson's 10-hospitalist group, the average bonus was $1,400. He predicts an average 2009 payment of $2,400 for members of his group.

Dr. Torcson expects more hospitalists will use the incentive program once more HM-specific performance measures are put in place, including yardsticks focused on care transitions and inpatient management of heart failure.

"This truly is the platform for the future pay-for-performance model that's going to affect every hospitalist," he adds. "I can't see any reason to ignore it.”

For more information about reporting PQRI measures, visit the CMS Web site and check out the PQRI toolkit. Visit SHM's Web site for information about getting your hospitalist program started in Medicare's voluntary pay-for-reporting program.

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