physician quality reporting s registry...state leadership conference – march 15, 2015 other...
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State Leadership Conference – March 15, 2015
PHYSICIAN QUALITY REPORTING SYSTEMREGISTRY
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State Leadership Conference – March 15, 2015
Year PQRS Incentive PQRS Payment Adjustment (penalty)
2014 + 0.5% Penalty, 2016 based on 2014 participation
2015 N/A - 1.5% (based on 2013 participation)
2016 N/A - 2.0% (based on 2014 participation)
2017 N/A - 2.0% (based on 2015 participation)
Why PQRS?Incentives and Penalties
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State Leadership Conference – March 15, 2015
How PQRS works
Reporting Options – CMS will use ‘Most Advantageous’
Claims-based – Individual measures
Registry – Individual measures, Measures Group, GPRO
EHR – Individual measures, GPRO
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State Leadership Conference – March 15, 2015
Why a registry and Why PQRSPRO (for EPs)
CMS statistics have demonstrated claims-based PQRS reporting to have only 56% success, whereas registry reporting is 96% and higher
Rules are confusing
More and more measures are not available through claims reporting
Measures groups available
PQRSPRO has over a 99% success rate
PQRSPRO had no measure calculation errors per CMS validation
PQRSPRO staff are available to assist eligible providers and their administrative staff
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State Leadership Conference – March 15, 2015
Measures for APAPO PQRS RegistryID Measure110 Preventive Care and Screening: Influenza Immunization
111 Pneumonia Vaccination Status for Older Adults
128 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
130 Documentation of Current Medications in the Medical Record
131 Pain Assessment and Follow-Up
134 Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
173 Preventive Care and Screening: Unhealthy Alcohol Use – Screening
181 Elder Maltreatment Screen and Follow-Up Plan
226 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
325 Adult Major Depressive Disorder (MDD): Coordination of Care of Patients with Specific Comorbid Conditions
383 Adherence to Antipsychotic Medications for Individuals with Schizophrenia
391 Follow-up After Hospitalization for Mental Illness (FUH)
402 Tobacco Use and Help with Quitting Among Adolescents
ALSO: the Dementia Measures Group!
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State Leadership Conference – March 15, 2015
Dementia Measures Group
ID Measure280 Staging of Dementia281 Cognitive Assessment282 Functional Status Assessment283 Neuropsychiatric Symptom Assessment284 Management of Neuropsychiatric Symptoms285 Screening for Depressive Symptoms286 Counseling Regarding Safety Concerns287 Counseling Regarding Risks of Driving288 Caregiver Education and Support
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State Leadership Conference – March 15, 2015
How the registry works
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State Leadership Conference – March 15, 2015
How the registry works – Measure Selection
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State Leadership Conference – March 15, 2015
How the registry works – Measure Selection
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State Leadership Conference – March 15, 2015
How the registry works – Measure Selection
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State Leadership Conference – March 15, 2015
How the registry works – Measure Selection
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State Leadership Conference – March 15, 2015
How the registry works – Measure Selection
Must select:
At least nine measures
At least three domains
Measures where the eligible provider (EP) will report
greater than 0% performance
At least one cross-cutting measure (EPs with any face-
to-face encounters)
Or opt for MAV
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State Leadership Conference – March 15, 2015
How the registry works – Measure Selection
Measure Applicability Validation (MAV)
Applies for those that submit less than nine measures or less than three domains
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State Leadership Conference – March 15, 2015
How the registry works – Dashboard
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State Leadership Conference – March 15, 2015
How the registry works – Chart Entry
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State Leadership Conference – March 15, 2015
How the registry works – Chart Review
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State Leadership Conference – March 15, 2015
Registry Validation
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State Leadership Conference – March 15, 2015
Registry Submission
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State Leadership Conference – March 15, 2015
Other Incentives from ReportingQuality Incentive programs utilizing reportingState-generated quality measures incentives, such as the Minnesota Quality Incentive Payment System (QIPS) & California Pay for Performance Program
Payor programs utilizing reports: Aetna - variety of programs Anthem Blue Cross and Blue Shield - variety of programs Blue Cross and Blue Shield – variety of programs CIGNA - several programs Geisinger Health Plan Harvard Pilgrim Health Care HealthPartners Integrated Healthcare Association MVP Health Care Rhode Island Department of Human Services, Blue Cross & Blue Shield of Rhode Island,
Neighborhood Health Plan of Rhode Island, and UnitedHealthcare of New England Tufts Health Plan UCare UnitedHealthcare/PacifiCare
Also consider your PQRS data for use in QI / PI initiatives, MOC, and PI programs
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State Leadership Conference – March 15, 2015
Portal opens March 2015 http://apapo.pqrspro.com
Webinars currently scheduled for: March 24 at 1 pm March 30 at 7 pm
Encouraged to report throughout year!
Can report through Feb 3, 2016
Reporting / Submission Timing
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http://apapo.pqrspro.com/
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