Physicians' participation in the Physicians' Quality Reporting Initiative and their perceptions of its impact on quality of care

Background: Medicare established the Physicians Quality Reporting Initiative (PQRI, recently renamed the Physicians Quality Reporting System) to increase reporting of quality metrics and promote healthcare quality. Objective: To identify characteristics of PQRI participants and examine their beliefs about its impact. Design: National survey of 4934 U.S. physicians, conducted June through October 2009. Setting: All practice settings. Participants: Randomly selected physicians categorized as primary care, medical specialists, surgeons, other specialists. Measurements: Beliefs about impact of PQRI reporting on quality. Results: The response rate was 49.8%. There were no significant differences between respondents and non-respondents by age, gender, specialty, and region. Thirty-eight percent participated in the PQRI, and were more likely than non-participants to be practice owners (69.0% vs. 57.1%, p < .0001) and to receive performance bonuses through their employer or practice (50.4% vs. 37.0%, p < .0001). Half of PQRI participants believed it had no impact on quality. Medical specialists (57.0%) and surgeons (55.1%) were more likely than primary care (40.4%) and other physicians (45.7%) to say that PQRI has no impact on quality (p = .004). Conclusions: Most PQRI participants believed it had little if any impact on quality. Medicare should identify the reasons behind physicians' negative views while it works to expand the Physicians Quality Reporting System. (C) 2011 Elsevier Ireland Ltd. All rights reserved.