Physician Quality Reporting System
What You Need to Know for 2014
Since 2007, the Physician Quality Reporting System (PQRS) has been a voluntary federal
program, offering Medicare incentive payments to physicians who report quality measure data
to CMS. However, the Affordable Care Act requires that CMS phase out incentive payments
and instead apply penalties by 2015 to physicians who fail to satisfy PQRS reporting
requirements. As a result, 2014 is the LAST year to qualify for a PQRS incentive payment and
those who do not satisfy the program’s requirements in 2014 will be subject to a penalty in
2016.
It is important to note that going forward, PQRS measure data also will be used, in combination
with cost-of-care-data, to calculate a separate performance-based payment adjustment known as
the Value-Based Payment Modifier (VBM). Group practices with >10 eligible professionals (EPs)
who do not satisfy PQRS reporting requirements in 2014 may be subject to a separate payment
adjustment of -2.0% under the VBM in 2016, for a total cut of -4.0%. More information about
the VBM is available at: http://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/PhysicianFeedbackProgram/ValueBasedPaymentModifier.html
Given the implications of these policies, it is critical that neurosurgeons understand the PQRS
and its various reporting options.
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