April 24, 2015
CMS Releases 2013 PQRS Report: Anesthesiologist Participation Rate Rises to 71.5 percent
On April 23, 2015, the Centers for Medicare & Medicaid Services (CMS) released its 2013 Reporting Experience, Including Trends (2007-2014) document detailing practitioner participation in the Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program. The full report and appendix can be downloaded from the CMS website.
As in previous years, anesthesiologists participated in PQRS at relatively high rate – 33,879 out of 47,408 anesthesiology eligible professionals (EPs) reported data to CMS. A closer breakdown of the reporting options for 2013 also demonstrate that anesthesiologists, similar to other specialties, relied heavily on reporting PQRS via the claims-based reporting option. In 2013, 79.4 percent of participating anesthesiologists reported via claims (26,914), 12.6 percent reported via the Group Practice Reporting Option (GPRO), 6.4 percent through the ACO Shared Savings Program and less than 2 percent reported via either the “Traditional” Qualified Registry or EHR reporting mechanisms. The Qualified Clinical Data Registry reporting mechanism for PQRS was not available in 2013.
Just over 80 percent of anesthesiologists who participated in PQRS that year successfully reported and were eligible for the 0.5 percent incentive payment. Anesthesiologists saw an average incentive of $219 while the maximum incentive paid to an anesthesiologist was $8,712. Total incentive payments for anesthesiologists, after sequestration, tallied $5,858,324.
Reporting PQRS in 2013 became increasingly important as the program transitioned from an incentive-based reporting program to one that included both incentives (paid in 2014) and payment adjustments (-1.5 percent applied on covered professional services in 2015). In late 2014, CMS sent letters to anesthesiology practices detailing if a payment adjustment would be applied in 2015. The report released today identified roughly 23.1 percent or nearly 11,000 anesthesiologists as eligible for the -1.5 percent adjustment.
ASA strongly encourages individuals and groups to participate in PQRS, as non-participation will lead to greater payment adjustments in the future. For more information on reporting PQRS this year, please visit the ASA PQRS webpage.
For questions on federal quality reporting programs, please contact the ASA Department of Quality and Regulatory Affairs at 202-289-2222 or [email protected].