American Society of Hematology

CMS Reports Results of 2010 Medicare PQRS and eRx Incentive Program

Published on: April 10, 2012

The Centers for Medicare & Medicaid Services' (CMS) results for the 2010 Physician Quality Reporting System and the 2010 Electronic Prescribing (eRx) Incentive Program show significant gains in participation and incentives paid to eligible health care professionals. The report, 2010 Physician Quality Reporting System and eRx Experience Report, identifies key areas in which physician-level quality measures point toward future measurable results in improved quality of care delivered to Medicare beneficiaries.

In 2010, 268,968 eligible professionals participated as individuals and part of group practices in the Physician Quality Reporting System program through all reporting methods, compared to 210,559 in 2009 and 153,839 in 2008. This represents approximately 26 percent of the 1,017,664 professionals eligible to participate. Among those participants, 193,666 (72 percent) were incentive eligible, compared to 57.3 percent in 2009 and 55.5 percent in 2008. Physician Quality Reporting System incentive payments in 2010 totaled $391,635,495, of which $364,254,804 was earned by individual eligible professionals (compared to $236,696,432 earned by individual professionals in 2009 and $95,080,976 earned by individual professionals in 2008).

Under the 2010 eRx Incentive Program, 696,663 professionals were eligible to participate, of whom 130,953 (18.8 percent) participated, compared to 89,752 (13.4 percent) in the 2009. Of those eligible professionals who submitted data on the eRx measures in 2010, 82,950 (63.3 percent) were incentive eligible, compared to 48,354 (53.9 percent) in 2009. eRx incentive payments in 2010 totaled $270,895,540, compared to $148,007,816 in 2009.

In line with results from the 2009 eRx incentive program, in 2010, physician specialties with the highest participation rate were cardiology (35.4 percent), ophthalmology (33.8 percent), and rheumatology (31.7 percent). Non-physician specialties totaled 10.2 percent of participants and, similar to 2009 results, the highest participation levels among the non-physicians were nurse practitioners and physician assistants.

The Physician Quality Reporting System and the eRx Incentive Program, combined, paid $662,531,035 in incentives in 2010 across all participation options, a 72-percent increase from 2009 ($384,704,248). The average incentive amount for individual professionals who satisfactorily reported was nearly $2,000 in the Physician Quality Reporting System for 2010 and more than $3,000 for successful electronic prescribers in the eRx Incentive Program.

More information about the Physician Quality Reporting System, including how eligible professionals can participate and the criteria for reporting to qualify for an incentive payment, is available in the PQRS section of the CMS website. More information on how to participate in the eRx Incentive Program as well as more information about the 2012 eRx payment adjustment is available in the eRx Incentive Program section of the CMS website.

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