Implementing the physician quality reporting system in an academic multispecialty group practice: lessons learned and...

Area of Science:

• Health Policy
• Healthcare Management
• Quality Improvement

Background:

• The Centers for Medicare and Medicaid Services (CMS) launched the Physician Quality Reporting System (PQRS) in 2007.
• PQRS aimed to link payment to quality and cost in ambulatory care.
• Jefferson University Physicians (JUP) was an early adopter of this voluntary pay-for-reporting program.

Purpose of the Study:

• To review the policy context of PQRS implementation.
• To detail JUP's strategy, lessons learned, benefits, and barriers in participating in PQRS.
• To assess the financial impact and implications of PQRS for faculty practice plans.

Main Methods:

• Review of the policy background and implementation strategy for PQRS at JUP.
• Analysis of JUP's participation rates and financial incentives/costs in 2010.
• Qualitative assessment of benefits and barriers encountered during participation.

Main Results:

• JUP achieved 94% provider participation in PQRS in 2010.
• Participating providers received an average incentive of $772.
• Total net incentives exceeded $171,000, offset by significant implementation and maintenance costs.

Conclusions:

• PQRS marked a significant step by CMS towards value-based care in ambulatory settings.
• Faculty practice plans must prepare for such initiatives to avoid penalties and improve care quality.
• Early participation in quality reporting programs presents both financial opportunities and operational challenges.