American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

Tool simplifies quality measure reporting

From the January ACP Internist, copyright 2013 by the American College of Physicians

The Physician Quality Reporting System (PQRS) can offer a good return on investment. While it is a voluntary program, starting this year there will be penalties for not participating.

Incentive payments, equal to 0.5% of allowed charges for services covered by the Medicare Physician Fee Schedule, ended after 2012. Now, clinicians who do not report PQRS measures in 2013 will incur a 1.5% deduction from their 2015 Medicare reimbursements. The negative adjustment will increase to 2% for future years.

Practices have several options to report quality measures. It may seem intimidating at first, but it is possible to spend a little time up front deciding the reporting method and the measures that are most applicable to a practice.

There are two principal decisions to make: what reporting method to use and whether to report individual measures or measures groups.

Claims-based reporting. To use claims-based reporting, clinicians can choose three or more measures. For instance, common measures for internal medicine relate to diabetes or congestive heart failure management or preventive care. Clinicians who choose this option will bill using specific codes for 12 months:

  • Individual measures. Clinicians must report on at least three measures and report at least 50% of applicable Medicare fee-for-service patients.
  • Measures groups. Clinicians must report on at least 30 patients during the 12-month period or, if fewer than 30 but more than 15, then at least 50%.

EHR-based reporting. To report directly from an EHR, the EHR must be PQRS-qualified. (Clinicians can ask their vendors if they qualify or check online.) Physicians who are participating in the 2012 Medicare EHR Incentive Program may satisfy the meaningful use objective to report clinical quality measures to CMS by reporting them through the PQRS-Medicare EHR Incentive Pilot, which uses specific 2012 Physician Quality Reporting EHR measure specifications.

Registry-based reporting. With this option, clinicians satisfactorily report on at least 80% of eligible encounters or report on a 30-patient sample (if reporting measures groups). Unlike the other options, which are tied to claim submittals, this option can be done retroactively. Additionally, the fact that only 30 patients are needed to qualify is very appealing.

ACP offers a registry tool, the PQRIWizard, that allows physicians to participate using the 30-patient measures group option. The process requires identifying patients who meet the criteria (such as using the practice management system), pulling the charts and then inputting data regarding the measures group. With well-organized charts, this process can take as little as two hours.

More details on each of these options, as well as how to access the PQRIWizard, are online.

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Advertisement

Share

 
 

Internist Archives Quick Links

What will you learn from your Annals Virtual Patient?

Annals Virtual Patient

Annals Virtual Patients is a unique patient care simulator that mirrors real patient care decisions and consequences. CME Credit and MOC Points are available. Start off with a FREE sample case. Start your journey now.

Internal Medicine Meeting 2015 Live Simulcast!

Internal Medicine Meeting 2015 Live Simulcast

Unable to attend the meeting this year? On Saturday, May 2, seven sessions will be streamed live from the meeting. Register for the simulcast and earn CME credit after watching each session. Watch it live or download for later viewing.