PQRS by the Numbers - 2014

Health & Human Svcs LogoCMS has released the PQRS specifications for the 2014 reporting period and as expected, they are full of changes. Since inception, the Physician Quality Reporting System, has greatly changed the coding and documentation landscape for Eligible Professionals and Group Practices. Reporting on quality measures has become a way of life for the practicing physician. Whether the reporting is being executed through a registry, allowed for most all standard measures and measure groups, or by individual physicians utilizing claims-based reporting, the additional time and monetary importance is not inconsequential. Physicians are being asked to do more and more each year so it’s vitally important for them to have an intuitive and robust system for collecting the data. Of course, that’s always been the challenge.

PQRS kicked off with 74 measures and, in the first year alone, retired 15 measures while expanding to a new measure high of #134. Here is a representation of how far CMS has brought the PQRS system and some of the highlights for this coming year:

2014 Highlights

New Measure High – #358

New Measures - 26

Retired Measures - 22

Total Available Measures - 201

Total Claims-Based Measures - 110

For 2014, physicians are being asked to do even more. Most of the reporting options now available, for Eligible Professionals or the Group Practice, require reporting for at least 9 measures across 3 of the National Quality Strategy domains. The domains for 2014 include the following - Patient Safety, Person and Caregiver-Centered Experience and Outcomes, Communication and Care Coordination, Effective Clinical Care, Community/Population Health and Efficiency and Cost Reduction.

CMS is also advising physicians that thorough reporting is essential to the program and those that report satisfactorily in 2014 may avoid the impending 2016 payment adjustments. Meeting the goals in 2014 could qualify physicians for 0.5% incentive while not meeting the requirements will create a 2% adjustment in 2016. Qualified Revenue Cycle Management companies, like MDeverywhere, and its state-of the-art Practice 1st solution, will help physicians properly select and report measures for 2014 by considering many factors – specialty, level of care, location and quality goals for the coming year. The last piece of the reporting puzzle is being sure to include PQRS data on the minimum number of Medicare insured patient visits, which depending on the reporting method, can be as high as 80%.

Further information on PQRS is available on the CMS website at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html

Information specific to the 2014 changes is available on the CMS website at:  http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html



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