When CMS released the final ruling for the MIPS program last month, there was a slight sigh of relief as the cost category was assigned a 0% weight factor for the 2017 performance year. With the MIPS “pick your pace” concept, it will be extremely easy and very tempting for eligible clinicians and groups to overlook the cost category in 2017, since it will have … Read the rest
The 2016 year is almost over and we are all busy making and hopefully marking off our holiday preparation checklists. So it is fitting to take a look at the PQRS checklist and get that big marker out to make checks on numbers one through ten. That is where you should be comfortable sitting at this point in the project and … Read the rest
For the 2017 reporting year, the MIPS Quality Category will account for 60% of the overall MIPS performance score. The Quality category replaces PQRS that eligible clinicians may already be familiar with.
Most participants will report 6 quality measures, including one outcome measure, for at least 90 days in order be eligible for a possible positive adjustment. For groups reporting … Read the rest
It’s the “final countdown” and the last month for collecting and reviewing your data for 2016 PQRS reporting. Here is a short list of ideas to improve your success for data submission.
1) Know the reporting requirements of your EHR vendor, Registry or other method that you are using. Monitor that data extracted fits the requirements.
It is November and you are happily pulling data from your EHR system in preparation of submitting through your selected reporting mechanisms. If your EHR is robust, you may be able to generate data in multiple formats and therefore may have options in the mechanism. Here is a brief overview of those mechanisms and the types of reports used to submit … Read the rest
The MACRA-Quality Payment Program encompasses the current legacy programs of PQRS, MU and Value Modifier. Therefore, if you have been engaged in all or some of these programs, the QPP will be familiar and not to be alarmed about. Here are some quick facts on the Quality Payment Program and items to consider at this point in time.
Identify … Read the rest
Let’s clarify, “right off the bat”, that reporting Measure Groups is only available if reporting individually and using the Registry submission method. It is not available if you have chosen GPRO, but is available if you are in a group and are still electing to report individually within the group TIN.
A measure group is defined as a subset of individual PQRS measures … Read the rest
The CMS Informal Review Request is a mechanism for providers and groups to request a review of negative payment adjustments for PQRS and the Value Modifier. This process allows individual Eligible Professionals, CPC practices, PQRS group practices and ACOs to request review of the payment adjustment determination.
When an informal review request is submitted, CMS will investigate whether a … Read the rest
No. Higher scores are not ALWAYS better for PQRS measures.
When assessing and choosing measures to report for PQRS do not always assume that higher is better. Be careful to consider the performance notations for the particular measure which shows whether the higher or lower number is best performance. For measures with inverse performance rates a lower performance rate actually … Read the rest
Remember the chart back on July 1 – Reporting Mechanisms? I have posted it again here since the mechanism you choose does affect the measures that you report.
The measures and the requirements for reporting are already defined for those that have chosen Individual Measure Group or GPRO Web Interface mechanisms. How to report for these mechanisms was addressed in … Read the rest
Because of the great response we have received on our MU blog, we have created a PQRS blog, where we will share information on the CMS PQRS (Physicians Quality Reporting System) program. This blog will help clarify PQRS eligibility and requirements, the value-based modifier program as well as the quality and cost measure information contained in the confidential quality and resource … Read the rest
This checklist was initially provided in the January blog post and is a good time to revisit to see where you are at in the steps for participation for 2016 PQRS. I hope you find yourself using this list, marking off those items completed and are now at around Item 7, choosing your measures! As of posting time of this blog, there have been … Read the rest
If you have selected GPRO Web Interface Reporting there are a few tasks that you could be doing now to be prepared for the submission period during the first quarter of 2017.
Choosing a Registry
Now that you have decided on Registry reporting for PQRS 2016 it is time to choose a Registry Vendor. Vendors can be very knowledgeable and valuable in selection and approach to determining quality measures to report. Some Registry websites have identified steps, they have videos to review and have experience in submitting and knowing the requirements. The CMS … Read the rest
If you haven’t started your PQRS reporting for 2016, there are a variety of tools to help you begin, including a 2016 Beginner Reporter Toolkit. The beginner-level toolkit contains two documents to help individual EPs and PQRS group practices navigate their way through the various PQRS decision points and the impact of quality reporting – Quality Reporting Roadmap… Read the rest
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 … Read the rest
The June 30th deadline for Group Reporting Option is past! Congratulations on completing this milestone in the PQRS reporting process. What is a next step in the PQRS Process? Measure selection is a valuable next step and provides an opportunity to align with other quality reporting programs in your organization. A focus on common measures for monitoring … Read the rest
PQRS has several reporting mechanisms for individual eligible professionals and group practices. The chart summarizes the methods available for reporting as Individual or as a Group. As you can see, all methods that were available in 2015 for reporting are available in 2016. Added, is the GPRO option to report through Qualified Clinical Data Registry. The method and requirements of reporting have limitations based on … Read the rest
CMS recently released the 2014 Reporting Experience Including Trends (2007-2015), referred to as the 2014 PQRS Experience Report.
The annual PQRS Experience Report provides data and trends on participation, incentive eligibility, incentive payments and payment adjustments as applicable since the beginning of PQRS, including measure performance and program participation broken down by specialty and geographic … Read the rest
Everyone is talking about workflows because they are a key factor in improving the use of your EHR! How data is being entered into your system affects the downstream functionality and quality reporting from your system. Entering data into the correct fields in your EHR ensures you will get the credit it for it on your MU … Read the rest
Deadline for Group Reporting Registration is June 30, 2016. Groups of 2 or more EPs can participate in PQRS using Group Reporting Option (GPRO), reporting methods. Remember from a previous post that when registering you will need to include the mechanism chosen for reporting. Here are the options available for group reporting.
At the time of registration you must indicate your submission method … Read the rest
CMS EIDM is CMS’s Enterprise Identity Management system, which provides a way for business partners to apply for, obtain approval of, and receive a single user ID for accessing multiple CMS applications. The PV-PQRS Domain in EIDM provides access for PQRS program information and various tasks such as viewing QRUR and feedback reports, submitting reporting data, and GPRO self-nomination. An EIDM … Read the rest
You may want to review your Medicare payments for adjustment codes from CMS for the Medicare Part B charges to determine if your organization is affected.
We recommend reading CMS How Do I Avoid the 2016 Medicare Quality Reporting Payment Adjustments? You will learn about the 2016 negative or downward payment adjustments for Physician … Read the rest
Recently the Centers for Medicare & Medicaid Services (CMS) posted the 2016 annual update for electronic clinical quality measures (eCQMs) for eligible hospitals and eligible professionals. Providers will use these updated measures to electronically report 2017 quality data for CMS quality reporting programs.
CMS updates the specifications annually to improve their alignment with current clinical guidelines … Read the rest
Registration to report as a group opened April 1, 2016 and closes June 30, 2016. Groups of 2 or more EPs can participate in PQRS using Group Reporting Option (GPRO) reporting methods. At the time of registration you must indicate your submission method –
The list of eligible professionals for the PQRS program is much broader than what you may be familiar with for Meaningful Use. PQRS eligible professionals (EPs) include Medicare physicians, practitioners and therapists. A complete list of eligible professionals and explanation of Medicare reporting can be found on the 2016 PQRS List of Eligible Professionals. Eligibility is focused around whether the provider … Read the rest
If you are new to PQRS there are many resources for learning about the program and ideas on steps for walking through the process. HTS has summarized these resources on a MPQHF-HTS PQRS General Information. You will find on this page the explanation of PQRS and the Value Modifier Program, eligibility, CMS steps for getting started, GPRO registration and … Read the rest
PQRS steps and decisions can be daunting for an organization or practice. So, to start out the new reporting year let’s keep it simple and look at the high level steps for participating in the PQRS program. This should serve as a guide to keeping you on track for tasks throughout the year.
