The physician quality reporting initiative (PQRI) is a voluntary program for reporting certain quality measures on Medicare patients in return for receiving a small bonus payment. However, the PQRI procedures are such that a large number of those who try to participate do not receive incentive payments. Also, many indicate that the small bonus for participation is not worth the effort and costs incurred. Furthermore, it has been found that many of the quality measures are not a good indicator of a favorable outcome, and do not clearly promote significant increases in the quality of patient care. However, penalties will be given from the year 2015 for not participating in PQRI. Also, it is expected that PQRI will be a precursor to Pay for Performance legislation, which will require mandatory participation by physicians. Therefore, participation in PQRI now is recommended by many experts, so that health care professionals can learn the procedures and make necessary adjustments in their practice procedures.