Participation in PQRS continued to grow in 2014 both in total numbers and in the percentage of eligible providers (EPs) who participated. According to the 2014 Reporting Experience Including Trends (2007-2015), referred to as the 2014 PQRS Experience Report, released by the Centers for Medicare and Medicaid Services last week, 1.32 million providers were eligible for the PQRS program, and a total of 822,810 (63 percent) EPs successfully participated through at least one reporting mechanism compared to 642,114 (51 percent) in 2013.
Also of note is how providers participated. Though the individual claims reporting method continued to be the most popular (286,289 EPs participated via individual claims), participation fell slightly in that category from the previous year, whereas the GPRO option was nearly as popular (261,156 eligible providers) and doubled in size from 2013. Both registry and EHR reporting also increased in 2014.
2014 was the last program year for providers to earn an incentive payment. The 2014 PQRS incentive payments paid out equaled $224,088,411. The average incentive was $383 per EP and $4,950 per group practice, with 585,037 EPs and 45,273 group practices receiving incentive payments. A total of $1,627,613,994 was paid over the eight years (2007-2014) that CMS provided PQRS incentive payments.
More than half of all eligible professionals avoided the reduction of 2 percent of their 2016 Part B MPFS charges, based on 2014 PQRS reporting. The remaining 558,885 eligible professionals were subject to the adjustment, and of those, 466,351 (83 percent) did not attempt to participate in PQRS.
The current reporting year (2016) is the last year for the PQRS program and 2018 will be the last year for PQRS negative payment adjustments. PQRS will then be consolidated, along with the Meaningful Use Program and the Value-Based Payment Modifier, into the Merit-Based Incentive Payment System (MIPS), which was established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
For more information about the 2014 PQRS Experience Report, download a copy from the CMS website.
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