MGMA: Medicare Physician Quality Reporting Programs Not Improving Patient Quality, Needlessly Complex

More than 82 percent of physician group practices responding to the MGMA Physician Practice Assessment: Medicare Quality Reporting Programs* research reported they actively engage in internal processes to improve clinical quality for the patients they serve. Despite this focus, practices were heavily critical of Medicare’s physician quality reporting programs and their impact on patients and practices. More than 83 percent of physician practices stated they did not believe current Medicare physician quality reporting programs enhanced their physicians’ ability to provide high-quality patient care.

In addition to the lack of effectiveness, physician practices reported significant challenges in complying with Medicare quality reporting requirements. More than 70 percent rated Medicare’s quality reporting requirements as “very” or “extremely” complex. In addition, a significant majority of respondents indicated these programs negatively affected practice efficiency, support staff time, and clinician morale.

Next year, 2015, will be a critical year for medical group practices participating under three main Medicare Part B physician quality reporting programs.* It will be the first year all three programs penalize physicians for reporting unsuccessfully, and penalties will continue to grow in future years. When added up, unsuccessful reporting in 2015 will subject physicians and other eligible providers to Medicare payment penalties as high as 11 percent, levied in future years.

“Medicare has lost focus with its physician quality reporting programs. Instead of providing timely, meaningful, and actionable information to help physicians treat patients, this has become a massive bureaucratic reporting exercise. Each program* has its own set of arcane and duplicative rules which force physician practices to divert resources away from patient care,” said Anders Gilberg, MGMA senior vice president of government affairs. “MGMA continues to advocate for a single-harmonized Medicare quality improvement initiative that standardizes reporting and supports physicians in their efforts to improve care for their patients.”

MGMA conducted the Physician Practice Assessment: Medicare Quality Reporting Programs research in October 2014. The assessment includes responses from more than 1,000 medical groups in which more than 48,000 physicians practice nationwide.

*Physician Quality Reporting System (PQRS), meaningful-use EHR Incentive Program, and the Value-Based Payment Modifier Program

Write a Comment

Your email address will not be published. Required fields are marked *