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Physician Quality Reporting System (PQRS)
HealthFusion® and the AOA® Team Up to Bring You Bonus CMS Incentives
The Physician Quality Reporting System (PQRS), formerly known as the Physician Quality Reporting Initiative (PQRI), allows physicians to earn additional government (CMS) incentive funds for simply providing high-quality healthcare to their Medicare patients. With PQRS, physicians are eligible to receive up to 1% of covered professional services paid to the provider per the Medicare Part B Physician Fee Schedule (PFS). While this may not seem like an overwhelming amount of money, it is government money paid to physicians for doing what you are already doing — providing high-quality healthcare to your patients.
With MediTouch EHR®, PQRS is even easier, thanks to our MediTouch® Health Maintenance (HM) reporting module and our partnership with the American Osteopathic Association (AOA®). With the MediTouch® Health Maintenance module, PQRS is integrated into the claim creation process, automatically creating a compliant file for each participating physician, so that your practice can ensure that eligible encounters are reported for the Quality Measures on which your practice is focusing. The file includes all of the required measures for the measure group in which the provider is enrolled. HealthFusion® supports two measure groups — Diabetes Mellitus and Preventative Care. Providers should only enroll in one of the supported measure groups. Each file must include 30 Medicare Part B patients, for the applicable measure group (CMS guideline). The MediTouch® HM reporting module will assist your practice in creating a file with 30 patients that meet each measure included in the measure group. Thanks to HealthFusion’s® partnership with the AOA®, HealthFusion® clients (AOA® members and non-members alike) are able to report to PQRS using the AOA’s® CAP registry.
AOA® CAP for PQRS via HealthFusion®
The AOA® Clinical Assessment Program (CAP) for Physicians is a performance measurement program developed by the American Osteopathic Association. The CAP for Physicians measures current clinical practices in the physician’s office and compares the physician's outcomes measures to their peers and national measures. In addition, the AOA® works with CMS as a certified PQRS registry (the PQRS registry model requires file submission to a certified registry, like the AOA®). MediTouch is the only EHR that connects directly to the CMS certified AOA® CAP registry. AOA® members who utilize the AOA® CAP for PQRS registry receive a $100 discount; the registry fee is $299 for non-AOA® members and just $199 for AOA® members.
Once you have signed up for the CAP for PQRS via HealthFusion® and you have 30 qualified patients for the measure group, HealthFusion® will automatically send your data to the AOA® CAP for PQRS system, most likely at the end of 2011. After the AOA® receives this file from HealthFusion, you will receive an email from the AOA® informing you that you are now ready to complete your registration for the program. You will be provided detailed instructions on how to login to the AOA’s® system, register, pay the fee and then review and submit your data for completion of the CAP for PQRS process.
Step-by-step directions on AOA® CAP registration for PQRS can be found on the AOA's® website. The AOA® also answers many frequently asked questions concerning the CAP for HealthFusion® PQRS.
PQRS Deadlines and Requirements
- The reporting period for 2011 is Jan. 1 - Dec. 31, 2011, and the AOA® registry must recieve the PQRS data by Feb. 1, 2012. Eligible professionals report on a designated set of quality measures for services provided between these dates. It’s not too late to start!
- CMS requires that each registry perform a validation of the data submitted. You may be selected to submit a few of your charts for a reabstraction.
- There is a $199 registry fee for AOA® members and $299 for non-AOA® members to report to CMS.
- PQRS reporting is voluntary; if the 1% does not exceed the registry fee, simply do not report, and pay nothing. Example: You have $100,000 in approved Medicare charges for the year; therefore 1% is a $1000 incentive payment. AOA® members: $1000 - $199 = $701; non-AOA® members: $1000 - $299 = $601
- CMS payments for PQRS 2011 will be made in fall of 2012.