PQRS Program

Background

According to CMS, The Physician Quality Reporting System (PQRS) is a reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by individual eligible professionals (EPs). The program provides an incentive payment to individual EPs that satisfactorily participate or satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services. Additionally, individual EPs that do not satisfactorily participate or satisfactorily report in the 2014 PQRS program year will be subject to a payment adjustment in 2016. Registration to participate for 2014 is April 1, 2014 – September 30, 2014.

How to Begin

  1. Determine if you are able to participate in the PQRS program. Click here for a list of eligible medical professionals.
  2. Review the program considerations on pages 4-5 of the 2014 Physician Quality Reporting System Implementation Guide.
  3. Decide if you want to participate to receive incentive payments or just to avoid the 2016 payment reduction. Use the 2014 Physician Quality Reporting System (PQRS) Implementation Guide for help.
    • If you want to participate to receive incentive payments and avoid the 2016 payment reduction, then begin following the decision tree on page 24 and click here
    • If you want to participate just to avoid the 2016 payment reduction, then skip the following steps, begin following the decision tree on page 34, and click here.
  4. Decide if you want to participate as an individual or group. Click here for information on reporting as a group.
    • Eligible professionals who choose to report 2014 PQRS individual measures should select at least nine clinically applicable measures across three National Quality Strategy (NQS) domains to submit in an attempt to qualify for a PQRS incentive payment.
  5. Determine which measures best fit your practice. Consider the reporting method when deciding. Azalea Health supports both Claims and Registry, but recommends the Registry method. Click here for information on the Registry method.

Additional 2014 PQRS INFORMATION

In 2014 EPS can satisfy PQRS by participating one of the 2 ways listed below: 


2014 EHR Meaningful Use EHR Incentive Program Reporting

In 2014 EPs no matter which stage MU the EP is attesting, he/she will need to report on 9 CQMs covering at least 3 National Quality Strategy domains for the reporting period of January 1 – December 31, even though the EP will only have to report on the other core and menu MU measures for a 3 month reporting period in 2014. (All of our 2014 CQMs will be labeled in the EHR as “Stage 2 CQMs” so make sure they know they have to choose from that list of CQMs when attesting for MU in 2014, whether they are attesting for Stage 1 or Stage 2.)
 
This document outlines EHR-based reporting for 2014 PQRS and this is an interactive tool I found which guides users step-by-step on how they can report only once for the 2014 Medicare Quality Reporting Programs, depending on how they they are eligible to participate. Both documents are great resources for you to provide to any of our clients/potential clients who ask about PQRS reporting in 2014 and plan to attest for MU in 2014. I have also posted these on the PQRS page on our training site!  
  • Click HERE to view 2014 Physician Quality Reporting System (PQRS): Electronic Health Record (EHR) Reporting Made Simple.
  • Click HERE to view Reporting Once for 2014 Medicare Quality Reporting Programs.

2014 Registry Reporting:

For those EPs who do not plan to attest for MU in 2014 but do still want to participate in PQRS in 2014, they will need to register with a qualified registry and submit the data directly to through their online registry. This document outlines registry reporting for 2014 PQRS. And here is a list of the 2014 Qualified Registries that you can send to the client to choose from. With this method of reporting, EPs will not generate CQMs from our system but rather choose 9 PQRS measures covering at least 3 domains. The measures they can choose from can be obtained by downloading the zip file in this link. And then creating clinical alerts in their EHR based on the measures chosen to remind themselves to capture certain data. They will then need to manually report on the data captured in their EHR by submitting it directly to through their online registry.