Report: Medicare reporting program participation means more work, more costs

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Medical group practices gain additional administrative work and costs from participating in Medicare’s quality reporting program, according to new research by the Medical Group Management Association (MGMA).

Medicare has hosted a voluntary program, the Physician Quality Reporting Initiative (PQRI), for two years for physicians to report codes to the government regarding “quality” protocols and services performed in their practices. The 2006 program was called the Physician Voluntary Reporting Program (PVRP).

MGMA surveyed program participants in September and October. The association asked respondents about their participation and satisfaction with the initiative, collecting data from 190 members, which represented more than 3,079 practicing physicians. The average respondent group was comprised of 19 physicians, the association said.

From the responses, 11 percent of practices participated in PVRP and 44 percent are reporting measures for PQRI. Nearly all responding practices that participated in PVRP chose to take part in the PQRI and are reporting five measures on average, the Englewood, Colo.-based MGMA said.

At the time of the program launch, MGMA members were concerned about the fact that medical practices must report clinical information through insurance claim forms. Administrators worried that this would create inconsistent interpretation of reporting measures and new overhead costs for practices, according to the association.

Medical groups participating in the Medicare quality program reported the following:

  • Approximately 35 percent indicated that they had to create an addendum to their “superbill” paperwork to capture information to report the quality codes;
  • On average, practices assigned one employee to the administration and oversight of program reporting;
  • Approximately 22 percent required additional staff support; and
  • Seventeen percent had to increase staff salaries.

“A fundamental challenge our members are experiencing with Medicare’s quality program is the additional administrative burden,” said William Jessee, MD, president and CEO of MGMA.

According to the results, respondents remain uncertain about how the reporting of PQRI measures correlates with an improvement in patient outcomes. Only 13 percent of participants surveyed rated the program’s helpfulness to patients as good or excellent; 16 percent rated improvement of care outcomes as good or excellent.

Respondents also indicated low satisfaction with the information they receive about the program. They rated the following measures below average: transparency to providers; whether the program is “beneficial and worthwhile to the practice;” and overall satisfaction with PQRI.