PQRS: What’s in my QRUR?
July 15, 2016
Written by Sarah Leake
The Quality Resource Use Reports (QRURs) are part of CMS’s Physician Quality and Value Based program which provides physicians with comparative information about the quality and cost of the care delivered to their Medicare fee-for-service patients. The report uses quality measures from the Physician Quality Reporting System (PQRS) as well as the information you report through claims.
What is the value of the QRUR report?
- Provides comparative quality and cost data for quality improvement purposes. CMS hopes that when you see this data you will alter your practice patterns in order to increase the quality of care you are providing while simultaneously decreasing your costs.
- Measures reflected in the QRUR are risk-adjusted, geographically standardized, and reflect the same techniques used for the VBM calculation. This preview will allow you to gauge how you may fare when the VBM is applied.
Where do I access my QRUR Report?
Individuals must be registered in EIDM and have Authorized Access with the correct roles.
- For TINs with two or more eligible professionals:
- PV-PQRS Group Security Official (primary or back-up)
- PV-PQRS Group Representative
- For solo practitioners (TINs with one eligible professional):
- PV-PQRS Individual (primary or back-up)
- PV-PQRS Individual Representative
Two types of QRUR ReportsWatch Full Movie Online Streaming Online and Download
CMS makes available two types of QRUR reports each year.
The Mid-Year QRUR was made available in April 2016 and reports the period of July 1, 2014 thru June 30, 2015 to providers and organizations at the TIN level and whom had at least one eligible case for one or more of the claims-based quality outcome or cost measures. The Mid-Year QRUR is for informational purposes only.
The Annual QRUR is issued for the period January 1, 2015 through December 31, 2015 and shows the TIN’s actual performance on all of the quality measures and cost measures that will be used to calculate the 2017 Value Modifier. The 2015 Annual QRUR will be available in the Fall 2016.
How does your Annual QRUR impact the Value Modifier?
The VBM is derived from a quality composite score and a cost composite score. The quality composite score summarizes a TIN’s performance on quality care for Medicare beneficiaries for as many as six, equally weighted quality domains and including the PQRS measures reported: (1) Clinical Process/Effectiveness, (2) Patient and Family Engagement, (3) Population/Public Health, (4) Patient Safety, (5) Care Coordination, and (6) Efficient Use of Healthcare Resources.
The cost composite score summarizes a TIN’s performance regarding resource use for its attributed Medicare beneficiaries, across two equally weighted cost domains – Per Capita Costs for All Attributed Beneficiaries and Per Capita Costs for Beneficiaries with Specific Conditions (diabetes, coronary artery disease, chronic obstructive pulmonary disease and heart failure).
You are encouraged to look at your QRURs and determine how to translate the data into actionable projects to improve the quality of care provided.
Links
2015 QRUR and 2017 Value Modifier
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