Medicare’s PQRI needs improvement
Medicare’s Physician Quality Reporting Initiative (PQRI), which encourages quality improvement in medical practices through the use of clinical performance measures on a variety of clinical conditions, is in need of a little quality improvement itself. Some excerpts from an October 29, 2008 statement from the American Medical Association:
More than six out of 10 physicians surveyed rated the program difficult, and only 22 percent were able to download the PQRI feedback report for their practice. To maximize physicians’ experience with the program and to encourage more to participate, the Centers for Medicare and Medicaid Services (CMS) should place a greater emphasis on early education and feedback. In addition, Congress should allow CMS to develop a process that allows physicians to appeal CMS judgments on inaccurate reporting.
Of those who were able to access their feedback reports, less than half found the information instructive. Of the physicians who asked for assistance from CMS, 59 percent rated their satisfaction with CMS responsiveness as none to low. Physicians who began reporting in July 2007 did not receive a feedback report until 12 months later, halfway through the program’s second year, making it impossible to fix any reporting problems. This may have contributed to the fact that nearly half of all PQRI participants did not receive any bonus payment. If reforms are not made to the program, physicians who participate in 2008 will not receive feedback reports until 18 months after initial reporting.
A suggestion: let a private company (or companies) collect quality data from medical offices and pass it on to Medicare.