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Pay-for-performance (or "P4P") programs offer financial rewards to clinicians who provide care that meets certain standards or "measures" intended to gauge quality and cost-effectiveness. In 2004, when it became apparent that the movement to incorporate P4P into Medicare was rapidly gaining ground, AGS stepped up its efforts on this issue.
AGS Pay-for-Performance Proposal
AGS Pay-for-Performance Position Statement
Learn about Pay for Performance
Background Material on the 2006 Physician Voluntary Reporting Program (PVRP)
PVRP Updated in 2007, Given a New Name: Physician Quality Reporting Initiative (PQRI) 
CMS' PowerPoint Presentation on the 2007 Physician Quality Reporting Initiative (PQRI) is now available
CMS now has over 50 Frequently Asked Questions about the Physician Quality Reporting Initiative (PQRI) available on its website
CMS Offers New Options for Physicians Reporting Quality Data
The Centers for Medicare and Medicaid Services (CMS) recently announced new options for doctors reporting data on the quality of their care. The new options are intended to increase participation in Medicare's Physician Quality Reporting Initiative (PQRI).
One option would include reporting data to a medical registry, which would provide the data to CMS. "Participating eligible professionals can choose to report data on either individual measures or groups of measures that capture a number of data elements about common care processes for diabetes, kidney disease, and preventive medicine," CMS said.
Another change would provide doctors with new reporting periods if they report on groups of measures. "Participants may now start reporting in July 2008 and still be eligible to receive an incentive payment" in 2008, CMS said.
"The improvements CMS is making will drive the creation of better models for collecting and analyzing clinical information," said Sen. Max Baucus (D-MT), Chairman of the Senate Finance Committee. "This move is a step in the right direction on the long, careful path toward linking physician payments to the quality of care they provide."
The PQRI, implemented in 2007, provided a bonus payment of 1.5% for doctors who reported data on quality measures in the last half of 2007. Over 100,000 eligible physicians reported quality measures during this period. Congress renewed the program for 2008, which includes 119 quality measures for reporting.
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Roughly 16% of Eligible Physicians Participated in 2007 Medicare Physician Quality Reporting Initiative
Roughly 99,000 physicians -- about 16% of those eligible to participate in Medicare's Physician Quality Reporting Initiative -- submitted reports at least once during the 2007 reporting period, according to acting Centers for Medicare and Medicaid Services (CMS) Administrator Kerry Weems. In a recent letter to the Senate Finance Committee, Weems noted that, in areas with the highest levels of participation in the PQRI, nearly 20% of eligible physicians submitted reports. The highest participation rates were among anesthesiologists, ophthalmologists and emergency care physicians.
Senate Finance Committee Chair Max Baucus (D-MT) commended CMS for its progress with the program, which offers participating physicians bonuses for reporting quality data, but noted that the agency needs to make more of an effort to ensure that Medicare pays for quality services .
"The proof lies in the results, and CMS must now take important steps to improve how it collects information about provider performance and expand opportunities for doctors to participate," Baucus remarked.
In December, President Bush signed legislation extending the 1.5% incentive payments for physicians who successfully report measures during 2008 and eliminating a cap on the calculation of incentive payments for reporting in 2008 and 2009.
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AMA and Collaborating Organizations Provide Online Tools to Assist Participants in 2008 Physician Quality Reporting Initiative
To assist physicians and other eligible professionals interested in participating in Medicare's 2008 Physician Quality Reporting Initiative (PQRI), the American Medical Association (AMA), has developed a set of tools that can help participants identify measures relevant to their practices and facilitate the data collection and reporting the initiative requires.
The 2008 PQRI, which began January 1, gives participating professionals an opportunity to earn bonus payments by successfully reporting data on 119 designated quality measures through claims submitted for services provided between January 1 and December 31.
The tools the AMA has developed -- in collaboration with the Centers for Medicare and Medicaid Services (CMS), Mathematica Policy Research, Inc, and the National Committee for Quality Assurance -- describe each of the quality measures and provide a "data collection sheet" and coding specifications for each.
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