Excel Healthcare Group Identifies 2014 Healthcare Needs and Trends by Kristie Brown, Matthew Caravana, et al - HTML preview

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image005.gifPhysician Quality Reporting System (PQRS)

 

Physician Quality Reporting System used to be called Physician Quality Reporting Initiative (PQRI). Physicians who want to show they provide quality services can join this program and they will get incentive payments if they report satisfactorily on quality measures. Starting in 2015 providers will lose incentive money if the data is not meeting the quality measures set forth by CMS.

You don't have to register or sign up to participate in PQRS, but you must meet the minimum reporting qualifications to get the incentive. For more information on how to report your data, visit

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/How_To_Get_Started.html

You must choose at least nine measures that your organization will meet or choose one measure group. These measures can be found at

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html

Here is an example of the first measure from 2013 (some measures change for 2014)

NQF #

PQRS #

National Quality Strategy Domain

Measure Description

Measure Developer

Reporting Options

0059

1

GPRO DM-2

Clinical Process/ Effectiveness

Diabetes Mellitus: Hemoglobin A1c Poor Control: Percentage of patients aged 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1c greater than 9.0%

NCQA

Claims, Registry, EHR, GPRO/ACO, DM Measures Group

 

Some organizations feel by meeting these quality measures, they provide the best care for patients in the industry. Since some of these measures are now required to meet Meaningful Use, they must have shown great improvement for their patients. For more information on Meaningful Use, see that section in this book.