Monday Musings

On April 29th, CMS released the 2013 Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program Experience Report. The PQRS/eRx Experience Report is released by CMS annually and provides trends on participation, incentive eligibility, and incentive payments since the beginning of PQRS, including measure performance and program participation broken down by specialty and state.

Among the highlights of the report are the results of the Bundled Payments for Care Improvement (BPCI) initiative which was launched in 2011. The BPCI initiative links payments for multiple services during an “episode of care” into a bundled payment. BPCI episodes initiate either with an inpatient stay or with post-acute services following a qualifying inpatient stay. CMS is continuing to implement the initiative, which is testing four models of care with hundreds of providers across the country.

The outpatient payment system where so much of wound care occurs will shift from volume to some method of capitation or bundled payments based on an episode of care. Are we ready for that? Statistics on the 2015 PQRS payment adjustment will be released to the public for the first time through this report. The full report can be found at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/AnalysisAndPayment.html.