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Medicare Quality Reporting Requirements Unmet By Most Physicians

A new shows that fewer than one-in-five meet Medicare Physician Quality Reporting System () requirements. Those that meet thresholds now receive a .5 percent Medicare bonus payment. In 2015, bonuses will be replaced by penalties for providers who do not meet requirements. As it stands, more than 80 percent of providers nationwide would face these penalties.

Researchers analyzed 2007-2010 PQRS program data and found that nearly 24 percent of eligible radiologists qualified for PQRS incentives in 2010 – compared to 16 percent for other providers. The study is published online in the Journal of the American College of Radiology.

“Near term improvements in documentation and reporting are necessary to avert widespread physician penalties. As it stands, in 2016, radiologists collectively may face penalties totaling more than $100 Million. Although not a specific part of this analysis, penalties for nonradiologists could total well over $1 Billion,” said Richard Duszak, MD, chief executive officer and senior research fellow of the . “Compliance with PQRS requirements has improved each year but more physicians need to act now: their performance in 2013 will dictate penalties for 2015.”


The Neiman Institute conducts and supports research regarding medical imaging use, quality and safety metrics, and human resources as medicine moves toward non-traditional, value-based payment and delivery. The data gleaned from these efforts will serve as the basis for true, evidence-based medical imaging and health care policy.

To read the study, visit: http://www.neimanhpi.org/

American College of Radiology