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June 2011
Clinical Practice Management
Report Details Participation and Payment Amounts for CMS Incentive Programs

A recent Centers for Medicare and Medicaid Services (CMS) report shows how many physicians, including ID specialists, participated in two key CMS incentive payment programs in 2009. The report also sheds light on the amount of incentive payments physicians and practices received for successfully meeting the programs’ requirements.

CMS paid out approximately $382 million in incentive payments in 2009 through the Physician Quality Reporting System (PQRS) and the Electronic Prescribing (eRx) Incentive Program, compared to only $92 million in total incentive payments in 2008, according to the report. CMS attributed the more than two-fold increase to the expanded number of quality measures, more reporting options, and the decision to increase the incentive amounts from 1.5 percent to 2.0 percent of eligible professionals’ (EPs) total Medicare charges.

Nearly 120,000 physicians and other EPs in 12,647 practices received PQRS incentive payments totaling more than $234 million. While EPs who reported on PQRS measures still accounted for a relatively small proportion of program participants (33,055), more than 90 percent of these individuals earned incentive payments. Only 50 percent of the 185,154 EPs who chose the claims-based reporting option earned incentive payments. Ultimately, 57 percent of PQRS participants received incentive payments (averaging $1,956) for the 2009 reporting period, representing about 9 percent of the total eligible professionals.  Of the 5,141 ID physicians who were eligible to report on PQRS measures in 2009, 605 (about 12 percent) attempted to do so, and 373 of these earned PQRS incentive payments averaging $2,185. 

Approximately 48,000 EPs (54 percent of EPs who participated), representing about 10,000 practices, received $148 million in eRx incentive payments in 2009. The average payment was just over $3,000 per eligible professional and about $14,000 per practice, CMS reported. Of the 4,364 ID physicians who were eligible to report on the e-prescribing measure in 2009, 524 (approximately 12 percent) attempted to do so, and 185 of these earned eRx incentive payments averaging $3,155. The full CMS report is available in the "Downloads" section of the “Overview” page on the PRQS web page, at

IDSA has concerns that many ID physicians who may be considered EPs under the eRx Incentive Program may not be able to meet the reporting thresholds due to their practice characteristics. See the May 2011 IDSA News and IDSA’s website for information on claiming an exemption from the eRx requirements. IDSA also recently submitted comments (PDF) to CMS related to this issue.



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