CMS Incentive Programs for Quality Improvement
To support the drive towards continual quality improvement in patient care and practice operations, the Centers for Medicare & Medicaid Services (CMS) administer several incentive programs.
Physician Quality Reporting Initiative (PQRI) was first implemented in 2007 as a result of section 101 of the Tax Relief and Health Care Act of 2006 (TRHCA), and was expanded as a result of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA), and the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).Electronic Prescribing (eRx) Incentive Program was launched in 2009 as part of MIPPA.
Physician Quality Reporting Initiative (PQRI)
The Physician Quality Reporting Initiative (PQRI) is a voluntary, quality reporting program. The program offers an incentive payment to individual eligible professionals (EPs) who satisfactorily report data on quality measures for covered professional services provided to Medicare Part B Fee-For-Service (FFS) beneficiaries.
The PQRI incentive payment is equal to 2 percent of the EP's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services provided during the reporting period.
Incentives for Electronic Rx (eRx) systems
The Electronic Prescribing (eRx) Incentive Program promotes the adoption and use of eRx systems. This is a separate incentive program for EPs who are successful, electronic prescribers and meet CMS-specified criteria. Eligible professionals do not have to participate in PQRI to apply.
The eRX incentive payment is equal to 2 percent of the EPs total estimated Medicare Part B PFS allowed charges for covered professional services provided during the reporting period.
How SFHCP helps you qualify for CMS incentives
Saint Francis HealthCare Partners (SFHCP) helps you through the qualification and application process for PQRI and eRx incentive programs.
SFHCP educates your staff about the incentive programs, explains the relevant measures groups and provides instructions on the process. SFHCP develops paper data collection forms for tracking measures group data, and will assist with tracking the success of the physician or practice reporting process upon request.
For more information
Contact SFHCP to learn more about PQRI.