In October of this year, the Medical Group Management Association surveyed 1000 physician groups to assess their perspective on CMS’ quality reporting programs–the PQRS, the EHR meaningful use reporting and the value-based purchasing items. (MGMA Survey) Payment penalties can be as high as a combined 11%. 83% of practices say they do quality improvement, without any federal prodding and 77% use evidence-based care protocols. The practices surveyed overwhelmingly stated that CMS’ programs are an extreme negative, with 84% saying the requirements don’t enhance patient care and 85% saying they detract from clinician productivity. 85% reported a negative effect on staff morale. Only 12% said the programs improve clinical decision-making. Changes in workflow, new administrative burdens and drain on financial resources are reported as the primary effect of these programs, with a strong perception of no benefit. Many practices are considering whether it is worth putting the resources into these programs in the future, as many perceived that although they made intense efforts to comply, the ended up being penalized anyway. The practices would be better off to skip the spending and accept the reduced reimbursement.
81% reported that in regard to 2015, they are concerned with the complexity of the programs, 75% were worried about the costs, and 76% about the unattainability of performance standards. Very high percents are also concerned about confusing and conflicting program requirements and lack of helpful or timely feedback. An overwhelming number would support a single harmonized quality program. The results of this survey should be a strong wakeup call to CMS, particularly since these are large sophisticated practices oriented toward quality improvement. Another factor to be considered is the growing body of research showing that compliance with all these quality measures has no impact on meaningful ultimate clinical outcomes, so what is the point of having them at all? This is typical bureaucratic bs, with people who think they know best dictating how physicians should conduct their business, without any regard to the costs or the impacts on patient care. Time to dump these programs.