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  • 1 in 4 Academy Members Used the IRIS Registry’s PQRS Reporting Options in 2014

    Nearly one in four U.S. Academy members used the IRIS® Registry to report for Physician Quality Reporting System in 2014. With the IRIS Registry:

    • Nearly 3,000 providers reported PQRS data using their EHR system.
    • More than 1,400 providers manually reported PQRS data using the qualified registry option.

    The Centers for Medicare and Medicaid Services hasn’t yet fully released PQRS experience data for 2014. However, data for previous years show that providers who reported for PQRS through their EHR system or a qualified registry had the highest success rate. This bodes well for 2014 IRIS Registry participants, whether they used the EHR-based reporting tools or reported manually via the qualified registry.

    2014 Results Affect 2016 Payment

    Physicians who didn’t successfully report in 2014 won’t get hit financially until 2016. Total 2016 penalties, for both PQRS and the value-based modifier, range from 2 percent to 4 percent, depending on practice size. CMS automatically penalizes providers under the value-based modifier if they do not successfully report for PQRS. In 2016, only practices with 10 or more providers face a value-based modifier penalty.

    Based on an Academy analysis of the most recent available PQRS data, ophthalmologists face an average payment reduction of $5,172. Providers in larger groups could see their payments reduced an average of $10,344.

    PQRS & Value-Based Modifier Cumulative Penalties: Based on Services Paid under the Medicare Physician Fee Schedule (PFS)

    2016 Penalties for 2014 PQRS Reporting

    Practice Size Penalty $100,000 $200,000 $300,000 $400,000 $500,000
    < 10 EPs 2 Percent $2,000 $4,000 $6,000 $8,000 $10,000
    10+ EPs 4 Percent $4,000 $8,000 $12,000 $16,000 $20,000

    Higher Stakes in 2015

    CMS increased future penalties tied to 2015 PQRS reporting.  Physicians who don’t successfully report this year could face 2017 penalties ranging from 4 percent to 6 percent based on their practice size.  All providers now face a potential 2017 value-based modifier penalty, but CMS will penalize larger practices more heavily.

    The Academy estimates that penalties would reduce average payments by $10,344 per ophthalmologist. Doctors in groups of 10 or more providers face larger cuts, averaging $15,516 in 2017. 

    2017 Penalties for 2015 PQRS Reporting

    Practice Size Penalty $100,000 $200,000 $300,000 $400,000 $500,000
    < 10 EPs 4 Percent $4,000 $8,000 $12,000 $16,000 $20,000
    10+ EPs 6 Percent $6,000 $12,000 $18,000 $24,000 $30,000

    To use the IRIS Registry for 2015 PQRS reporting, you must sign up by Oct. 31.