PQRS is a Centers for Medicare and Medicaid Services (CMS) program designed to encourage physicians and other eligible professionals to conduct industry-recognized quality measures and report them to CMS. Both monetary incentives and penalties are attached to the program. In addition, CMS’ Physician Compare website has begun listing physician participation in PQRS, among other quality programs. This could mean a loss of new patients based on nonparticipation in the program.
The 10 Things
The Clinical Quality Measure (CQM) requirements are the same in 2015 for both PQRS and Meaningful Use. Now both programs use the same 64 measures.
Nine CQMs from 3 different National Quality Strategy (NQS) domains are required to report for PQRS 2015, depending on specialty.
The reporting period for PQRS is 12 months in most cases.
The penalty for not reporting 2015 PQRS is 2% of 2017 Medicare payment; for the average practice, this could mean a loss in revenue of up to $5,000. Practices are subject to an additional penalty under the Value-Based Modifier program.
5. Avoiding Penalties
To avoid the penalty and associated issues, report at least 3 measures on at least 50% of all appropriate Medicare patients (EHR method excluded).
The simplest option for individual reporting is through an EHR that is Stage 2 Meaningful Use Certified, Not every EHR is certified for all 64 CQMs; use one that is certified for multiple CQMs for more flexibility in reporting. EHR reporting is not tied to the typical PQRS 50% threshold.
The following professionals are eligible to participate in PQRS Medicare Physicians Doctor of Medicine Doctor of Osteopathy Doctor of Podiatric Medicine Doctor of Optometry Doctor of Oral Surgery Doctor of Dental Medicine Doctor of Chiropractic Practitioners Physician Assistant Nurse Practitioner* Clinical Nurse Specialist* Certified Registered Nurse Anesthetist* (and Anesthesiologist Assistant) Certified Nurse Midwife* Clinical Social Worker Clinical Psychologist Registered Dietician Nutrition Professional Audiologists *Includes Advanced Practice Registered Nurse (APRN) Therapists Physical Therapist Occupational Therapist Qualified Speech-Language Therapist
If you have more than 10 providers, you either report via the Group Practice Reporting Option (GPRO), or, more simply, make sure that 50% of your providers report successfully through their EHRs.
Individual EPs are not required to register to participate.
10. How to Participate in PQRS in 2015
-Choose which CQMs you will report
-Monitor your performance during the year
-Be sure that your EHR vendor can create a submission ready PQRS QRDA data file
-Make sure that your PQRS QRDA file is submitted to CMS in the beginning of 2016 Note that for the easiest reporting, you will need an EHR that is Stage 2 Meaningful Use Certified, certified to the June 2013 version of the eCQMs, and can create a QRDA file containing your data at the end of the year. Not all EHRs meet these qualifications, so you will want to check that your EHR qualifies.
Painless PQRS Reporting
With MediTouch, PQRS-compliance is as simple as performing basic Health Maintenance and Preventive Care in our EHR. MediTouch has already adopted the approved version of the PQRS CQMs and as an offi- cial CMS EHR PQRS 2014 vendor, we already have a track record of assisting providers with successful PQRS submissions.