The Invisible Two Percents

No one seems to mind two percent.

“Mrs Jones, you have a 98% chance of doing well with your surgery.” Most of us would leap at those odds when two percent is couched that way.

But like banking computers that round the penny in the bank’s favor, two percent can add up remarkably fast. Even worse, it's hard to track lots of 2 percents if they happen over and over again.

Now take a moment and think of all the places where the government has decided to withhold two percent from physicians lately:

“EPs (eligible professionals) who do not demonstrate that they are meaningful users of certified EHR technology will receive an adjustment to their fee schedule for their professional services of 99 percent for 2015 (or, in the case of an eligible professional who was subject to the application of the payment adjustment under section 1848(a)(5) of the Act, 98 percent for 2014), 98 percent for 2016, and 97 percent for 2017 and each subsequent year.”

“CMS Electronic Health Record Incentive Program Final Rule,” Federal Register, 28 July 2010

“Beginning with the 2010 eRx Incentive Program, a group practice may also potentially qualify to earn an eRx incentive payment equal to 2% of the group practice's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during the 2010 eRx reporting year based on the group practice meeting the criteria for successful electronic prescriber specified by CMS.”CMS eRx Incentive Program

“Eligible professionals who satisfactorily report quality-measures data for services furnished during a PQRI reporting period are eligible to earn an incentive payment equal to a percentage of the eligible professional's estimated total allowed charges for covered Medicare Part B Physician Fee Schedule (PFS) services provided during the reporting period.

Below are the authorized incentive payment amounts for each program year:
• 2007 PQRI – 1.5% subject to a cap;
• 2008 PQRI – 1.5%;
• 2009 PQRI – 2.0%; and
• 2010 PQRI – 2.0%.
(Note that these “incentives” are actually withheld by CMS until they are “earned” back)

Physician Quality Reporting Initiative

With each of these incentives comes ghastly and nearly uninterpretable governmental paperwork requirements to retrieve all those 2 percents. Take, for instance, this detailed example of the form that must be completed to recoup 2 percent (90 cents!) of a single $45 office charge based on PQRI measures.

Oh. My. Goodness.

And tracking that "incentive" payment to assure payment? Best of luck.

The governmental two percents. Going… going… gone.

Over and over again.

That, my friends, is what doctors must now accept if they're going to survive in our new era of health care "reform:"

.. the invisible, burdensome, and untraceable two percents... all soon to be "bundled" away.

-Wes