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40% of doctors choose fines over quality reporting compliance, CMS says

Doctors have called the programs confusing and time-consuming and say they offer little clinical benefit.

Susan Morse, Associate Editor

Doctors have called the programs confusing and time-consuming and say they offer little clinical benefit while detracting from their ability to care for patients.Doctors have called the programs confusing and time-consuming and say they offer little clinical benefit while detracting from their ability to care for patients.

While the Centers for Medicare and Medicaid Services said more physicians are participating in a reporting system designed to reward value of care over volume, 40 percent of doctors would rather take a 1.5 percent pay cut than participate.

CMS is paying out more than $380 million in incentive payments through its Physician-Quality Reporting System and Electronic-Prescribing Incentive Program.

[Also: Medicare penalizes 721 hospitals over medical errors [full list]]

Close to 642,000 healthcare providers complied in the 2013 reporting year, earning a .5 percent boost in payments in 2015. But more than 460,000 providers out of 1.2 million who were eligible opted to absorb a 1.5 percent pay cut due to non-participation in PQRS, according to CMS figures. An estimated 257,000 providers are also seeing a 1 percent pay cut for not meeting targets for the use of electronic medical records.

Doctors have called the programs confusing and time-consuming and say they offer little clinical benefit while detracting from their ability to care for patients.

Of non-participating physicians, 70 percent treat fewer than 100 Medicare patients a year; 43 percent treat fewer than 25 patients, raising speculation that these doctors may have found it less burdensome to pay the penalty than do the paperwork.

Specialties with the lowest numbers of participating professionals include psychiatrists and general practitioners.

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The number of participating providers has increased since the program was implemented in 2007.  The program originally gave payment incentives for quality reporting.

Starting this year, the Affordable Care Act mandated penalties for not participating. Penalties increase each year, and are levied two years after the reports are due.

The higher numbers in clinical quality reporting reflect both an increased use of electronic prescribing as well as a rise in the number of providers tracking and reporting quality measures.

[Also: SGR bill puts more onus on quality reporting]

The CMS report released this month said participation in the quality-reporting program had grown from 15 percent of those eligible in 2007 to 51 percent last year. It also said it is working to streamline the overlapping quality-reporting mandates to make reporting less burdensome.

Recent legislation replacing Medicare’s sustainable growth rate formula is only expected to increase quality reporting incentives.

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