The Medicare Physician Quality Reporting Initiative : perceived costs and return on investment influencing participation

Abstract

The US health care industry is widely held view that it is failing in its ability to provide, safe, high quality care for its citizens. Escalating financial costs and regional variability in the provision of care have prompted a change in tactics for public health care administered by CMS (Centers for Medicare and Medicaid) to a "Value-based purchasing" strategy. The Physician Quality Reporting Initiative (PQRI) is a federally funded, voluntary initiative aimed at encouraging community physicians to participate in the growing concept of value-based patient care. The initiative includes a financial incentive for MD's to provide their Medicare practice data to CMS, yet early results have identified little interest. The investment costs associated with PQRI participation and satisfaction with the perceived rewards of the program were explored. Partnering with the American Medical Association (AMA) and Massachusetts General Hospital (MGH) occurred to determine physician attitudes that influenced participation in this initiative and future strategies of value based reimbursement. Utilizing a provider attitude survey, data was obtained on the return on investment for participation, including perceived costs associated with data entry, negative incentives that may be preventing physicians from considering the initiative and attitudes toward quality initiatives and physician payment. This study adds novel information to the literature regarding physician interest in improving quality of care as health care reform increasingly focuses on quality and patient value.