Medicare’s Physician Quality Reporting Initiative: The New Frontier on Pay for Performance

letext">physicians who effectively report data on certain
Recently, the Centers for Medicare and Medicaidquality of care measures. Medicare officials have
(“CMS”) entered into the pay forstated that the data will allow the government to
performance arena with the Physician Quality“reward doctors who follow clinical guidelines
Reporting Initiative (“PQRI” orand perhaps penalize those who flout such standards
“Initiative”) aimed at improving thewithout justification.” The pay for
quality of health care. Participants in the Initiative,performance PQRI for 2007 became effective on
which is currently a pilot program, shall have to focusJuly 1, 2007 and runs through December 31, 2007.
on quality care through reporting. Under the TaxAny bonus earned in 2007 shall be paid out in a single
Relief and Health Care Act of 2006consolidated incentive payment in mid-2008. The
(“TCHRA”), Medicare provides for aPQRI will be expanded and the bonus cap increased
1.5 percent bonus, of total allowed charges forin 2008.
covered physician fee schedule services, to those