Medicare Announces Performance Measures for New Physician Quality Reporting Program

February 22, 2007 – Medicare has announced preliminary information and the performance measures for the 2007 Physician Quality Reporting Initiative (PQRI). The hematology measures created by ASH™ have been approved and included in the program.

The Tax Relief and Health Care Act of 2006 (TRHCA) enacted this past December authorizes the establishment of a physician quality reporting system by the Centers for Medicare and Medicaid Services (CMS) known as the Physician Quality Reporting Initiative (PQRI).

PQRI establishes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007, may earn a bonus payment, subject to a cap, of 1.5 percent of total allowed charges for covered Medicare physician fee schedule services. This initiative applies to the traditional Medicare fee-for-service program only and is not applicable to the Medicare Advantage Plans, including the private fee-for-service plans.

Last year ASH created a Pay-for-Performance Task Force to develop hematology-related performance measures that could be incorporated into a future Pay-for-Performance/Pay-for-Reporting program. The American Medical Association Physician Consortium for Performance Improvement and the AQA recently approved the ASH hematology-specific quality measures.

CMS has posted a new Web site for the Physician Quality Reporting Initiative.