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CMS Reviews PQRS reporting from 2015

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CMS Reviews PQRS reporting from 2015

CMS Reviews PQRS reporting from 2015 July 7, 2017

The Physician Quality Reporting System (PQRS) was initiated by the Centers for Medicare and Medicaid Services (CMS) to encourage “individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare.” The last program year for PQRS was 2016. CMS has since transitioned to the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

CMS recently released their findings on participating providers’ reporting experience for the 2015 PQRS. In their report CMS “assessed existing quality programs, provider participation, and rates of satisfactory reporting to gain insight into aspects of PQRS proving most challenging for providers,” according to a summary published in EHR Intelligence. Their report provided data on the number of providers who were satisfactorily able to participate in PQRS, to determine which reporting methods were most effective.

In their study, CMS found that “for registry, EHR and QCDR, 100% of eligible professionals who participated were able to satisfactorily report at least one measure while only 80% of eligible professionals who participated through claims were able to do so.” In addition, “eligible professionals reporting via EHR and QCDR were most likely to report 9 or more measures (96 percent of those using EHR and 86 percent for QCDR), compared to only 38 percent of those participating via registry and 4 percent of those reporting via claims.”

As the agency transitions to MIPS, part of the Quality Payment Program (QPP) under MACRA, their PQRS report may provide some insight into physicians’ ability to be successful with the new payment program. However, CMS did stress in their report that “program eligibility and quality measure requirements (are) areas where MIPS diverges significantly from the previous federal incentive program.” Quality reporting requirements should be “significantly less burdensome and complex” in MIPS.

Elation’s EHR solution also helps reduce the burden of everyday practice management, billing, and reporting for independent physicians. At Elation, we are focused on bridging that enormous chasm between the world of policy and payers, and the world of the front-line physician, to enable physicians to focus on quality patient care.