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PQRI is a program of the Centers for Medicare and Medicaid which provides information about certain standard of care measures. The program was started in 2006 by Congressional Act and made permanent in 2008. The initial act provided monetary incentives for providers who participate but this money is only assured through 2010. The complete rules and regulations are beyond the scope of this article, but initial information about the program follows.

The PQRI relies on nine different reporting options based on the time period of reporting, registry based reporting, and the measures which are reported. The measures are standards of care which are updated each year. The Centers for Medicare and Medicaid web site provides additional information about the program an is updated every year. Additionally, the AMA web site, specialty medical board web sites, and most state medical societies have information about the program.

Provider participation at this point is voluntary but does come with a maximum 2.0% monetary bonus for those who do participate. Participation has not been universal for many reasons. Some billing systems do not readily accept the codes necessary for reporting, some physicians find it rather cumbersome determining the appropriate reporting codes for each patient, and smaller practices often do not receive a return on the investment to report.

For physicians who may not be able to report individual measures, there is another option with reporting of prescription habits for Medicare patients. This reporting has an incentive bonus of 2.0% as well separate from the PQRI reporting. More information can be obtained from the Centers for Medicare and Medicaid website.

The idea of quality improvement in medicine is a current hot topic of debate. While most, if not all physicians agree that it is essential to establish standards of care and studies to demonstrate efficacy of procedures, there is no consensus on the best methods for those studies or determining compliance. In addition, not everyone will fit into the standard that is defined. There must always be some room for individual physician decision making.

Dr. D.J. Verret is a facial plastic surgeon in north Dallas, Texas. For more information about the PQRI program, visit the PQRI site

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