PQRS: An Overview of the Physician Quality Reporting System Don Gettinger, BS, CHTS-IM
2014 Physician Quality Reporting System (PQRS) and QRS
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Transcript of 2014 Physician Quality Reporting System (PQRS) and QRS
2014 Physician Quality Reporting System (PQRS) and QRS
Scott WeinbergSpecialist, Quality Care & Patient Access
What is PQRS?
• CMS program (Medicare only)
• Physician Quality Reporting System– Previously known as PQRI
• Provides a financial incentive to physicians who report on best practice quality measures for the Medicare patients they treat.
Why Report Quality Measures?
• Participants can receive a percentage (0.5% in 2014) of total allowed Medicare Part B charges for the 12-month period.
• Reporting quality measures in 2014 to avoid a 2.0% penalty in 2016.
Who Should Participate?
• All MD, DO, PA, NP, CNS, APRN who are reimbursed under the Medicare physician fee schedule.
• QRS is available to members and non-physician clinicians who are supervised by AAD members.
How Many Quality Measures in 2014?
To earn a 0.5% incentive and avoid a 2.0% payment reduction…
• Report at least 9 measures
• Report at least 50% of applicable patients for each measure for the full year
• Measures should cover at least 3 quality domains (done automatically through registry)
To only avoid the payment reduction…
• Report at least 3 measures
• Report at least 50% of applicable patients for each measure for the full year
• Measures should cover at least 1 quality domain (done automatically, by definition)
Quality Domains
1) Patient Safety
2) Person and Caregiver-Centered Experience and Outcomes
3) Communication and Care Coordination
4) Effective Clinical Care
5) Community/Population Health
6) Efficiency and Cost Reduction
5 Dermatology-Specific Measures (registry only)
1) Measure #137 — Melanoma: Continuity of Care — Recall System
2) Measure #138 — Melanoma: Coordination of Care
3) Measure #224 — Melanoma: Overutilization of Imaging Studies
4) Measure #265 — Biopsy Follow-Up
5) Measure #337 — Tuberculosis Prevention for Psoriasis and Psoriatic Arthritis Patients on a Biological Immune Response Modifier
8 Dermatology-Applicable Measures (included in AAD registry)
• Measure #130 — Documentation of Current Medications in the Medical Record
• Measure #131 — Pain Assessment and Follow-Up • Measure #173 — Preventive Care and Screening: Unhealthy Alcohol Use –
Screening • Measure #194 — Oncology: Cancer Stage Documented • Measure #205 — HIV/AIDS: Sexually Transmitted Disease Screening for
Chlamydia and Gonorrhea• Measure #226 — Preventive Care and Screening: Tobacco Use: Screening
and Cessation Intervention• Measure #245 — Chronic Wound Care: Use of Wound Surface Culture
Technique in Patients with Chronic Skin Ulcers (Overuse Measure)• Measure #246 — Chronic Wound Care: Use of Wet to Dry Dressings in
Patients with Chronic Skin Ulcers (Overuse Measure)
Measures with Large Denominators
• Measure #130 — Documentation of Current Medications in the Medical Record
• Measure #131 — Pain Assessment and Follow-Up
• Measure #173 — Preventive Care and Screening: Unhealthy Alcohol Use – Screening
• Measure #226 — Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Choosing a Filing Type
Selecting Your Measures
Dashboard
User Profile
TIN & NPI
Chart Abstraction
Patient Visit Review
Validation
Important for Successfully Reporting
• Have one eligible instance for each measure• Report at least 50% of applicable
patients/visits for each measure• No measure can have 0% performance• If reporting 9 measures, select across 3
quality domains (automated in QRS)• Enter your NPI and TIN correctly into the
module
2014 QRS Timeline
Questions?
• Current QRS users: [email protected]• General PQRS Questions: [email protected]• CMS QualityNet Help Desk: [email protected] • AAD Member Resource Center: 866-503-7546• Visit www.aad.org/QRS to:
• Purchase the AAD QRS Registry• View online tutorials FAQ sheets• See coding specifications for reporting these measures• Latest information