tive. “If I don’t agree with a particular bullet point on bone density testing only for patients over the age of 65 when there aren’t any other risk factors, I can drill down into the literature to find out where that comes from.” And AHRQ’s multilayered vetting pro- cess of the available research involves more rigor than most doctors have time for, Dr. Villamaria adds. “So we can be pretty confident that what the final report says is a good sum- mary of our knowledge at that point in time. And it’s really helpful to have the bottom line on what works for doctors who are busy seeing so many patients a day and really don’t have the hours to go and do these analyses on their own,” he said.
The only concern the council mem- bers expressed was over the hurdle ARHQ faces, just like doctors do, in keeping pace with the latest scientific evidence, given health care’s rapid ad-
vances. With diabetes in particular, new classes of drugs continue to hit the mar- ket, Dr. Ehrlich notes. Recognizing that challenge, Dr. Jana- kiraman says AHRQ reviews its reports annually to learn whether publication of additional studies changes the existing evidence base. For example, physicians and patients might see a banner on the website ex- plaining that the conclusions in an older report either remain valid or are under review and should be considered with caution. The brochures also tell physi- cians and patients how many studies AHRQ reviewed and the time frame of those studies. For the most part, Dr. Villamaria says physicians can’t go wrong by incorporat- ing the resources into their quality im- provement tool belts. “Treating patients in the most evidence-based manner is always going to be the best choice.”
CMS doles out PQRS, eRx bonuses as incentives shift to penalties
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Physicians and other eligible health pro- fessionals earned $503.1 million in 2012 through two Medicare quality improve- ment programs, the Physician Qual- ity Reporting System (PQRS) and the Electronic Prescribing (eRx) Incentive Program, according to the Centers for Medicare & Medicaid Services’ (CMS’s) 2012 Experience Report. But Texas Medical Association offi- cials caution many of the incentive pay- ments for Medicare’s quality reporting initiatives soon will shift to penalties based on physician performance. This year, 2014, is the last year eli- gible physicians can earn a PQRS bo- nus, and those who do not successfully participate in the program in 2014 face a 2-percent pay cut starting in 2016. That’s because CMS policy generally back-dates the reporting requirements, meaning physicians face a penalty based on their performance in the year or two prior.
Last year, 2013, was the last year physicians could earn an eRx incentive, and physicians who do not e-prescribe face a 2-percent penalty in 2014. According to the latest report from CMS, participation in both programs in- creased every year since their inception in 2007 (PQRS) and 2009 (eRx), and most of those participants successfully reported and qualified for an incentive payment. Those figures represent “con- tinued progress toward the CMS’s goals of promoting quality measure reporting for Medicare beneficiaries and align- ment across quality measure reporting programs.”
Hard Hats for Little Heads is made possible through a grant from TMA Foundation thanks to top donors — Blue Cross and Blue Shield of Texas, Prudential, and two anonymous foundations — and generous gifts from physicians and their families, and friends of medicine.
52 TEXAS MEDICINE June 2014
Physicians earned a total of $167.8 million in PQRS bonuses in 2012. That number represents the participation of 29,254 physician group practices and 367,228 “eligible professionals,” which include physicians, physician assistants,
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