Doctors likely to suffer quality reporting penalties

Most physicians who participate in Medicare will incur penalties in 2015 if they don't boost their performance with the program's Physician Quality Reporting System (PQRS) now, according to a new study published in the Journal of the American College of Radiology. This is the reporting year for 2015, when the PQRS carrot turns into a stick for physicians who don't comply.

For the study, the Harvey L. Neiman Health Policy Institute, established by the American College of Radiology, analyzed radiologists' experiences during the first four years of PQRS from 2007 through 2010. According to the researchers, 24 percent of eligible radiologists met criteria for PQRS incentives in 2010, while only 16 percent of all other providers were qualified.

If this trend continues, more than 75 percent of radiologists--who outperformed other Medicare providers studies--may face mean penalties of at least $2,654 in 2016, totaling an estimated $111,393,067 for the entire profession.

"Near-term improvements in documentation and reporting are necessary to avert widespread physician penalties," Richard Duszak, CEO of the Harvey L. Neiman Health Policy Institute, said in a statement.

Part of the problem, the researchers noted, was physicians' "frustration with internally contradictory program instructions and explanations from CMS," according to PhysBizTech. These difficulties, combined with startup costs, led some participating radiologists to conclude that the effort they put into the program far outweighed the rewards.

These frustrations are not unique to radiologists. Last year, most physicians who were eligible for bonuses did not participate, the Hill's Healthwatch noted. Among those who did submit data, nearly half--about 90,000--failed to earn bonus money.

To learn more:
- see the study from the Journal of the American College of Radiology
- read the post from the Hill's Healthwatch
- check out the story from PhysBizTech

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