decisionhealth Newsletters, Answer Books - 2009 Issue 7 (July)
Pay for Performance / Medicare's PQRI gives P4P financial incentive
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Article Overview
This article covers Medicare’s Physician Quality Reporting Initiative (PQRI) and its role in the broader pay-for-performance movement. It is aimed at coders, billers, and practices trying to understand how the reporting program works, why it matters for Medicare reimbursement, and what general submission issues can arise when reporting quality data. The discussion also places PQRI in the context of related Medicare quality reporting efforts and program history.
Why This Topic Matters
The article is relevant for practices that want to understand Medicare quality reporting participation and the potential financial incentive tied to reporting. It helps readers assess the administrative impact of PQRI and the need for systems that can support quality-data submission.
What You Will Learn
- The background and purpose of Medicare’s quality reporting initiative
- How the program relates to broader pay-for-performance efforts
- The general reporting structure and incentive concept
- Operational considerations for submitting quality data through billing systems
Who Should Read This
- Medical coders
- Billing staff
- Practice administrators
- Physician practices
- Compliance staff
Codes Discussed
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