For many practices, PQRS is a four-letter word. PQRS, or Physician Quality Reporting System, is a federal program that requires the large majority of medical practitioners to submit data annually on their patient encounters. If they fail to do so, they get dinged on their Medicare reimbursements. The program is intended to standardize the quality of health care across the country, but it’s also causing many headaches and sleepless nights for medical practices along the way. PQRS isn't going away, either. In fact, it has more or less been renamed "Quality" measures under the MIPS program starting this year.
Practices who are eligible for PQRS reporting have a couple of options for reporting their data, depending on their Medicare volume and what kind of data they have (or haven’t) captured in 2016. And for practices that haven’t started yet, it’s not too late. Some PQRS registries will allow you to submit your data as late as February 28.
Measures Groups reporting allows practices to submit data on just 20 patients per provider, and not all of those patients have to be Medicare! You must select one of CMS’ approved groups, such as Diabetes, Heart Failure, Preventative Care, Oncology, and more. These groups include a specific set of applicable measures you will need to report on.
Individual Measures allows practices to choose 9 measures to report on, but they must report these measures for at least 50% of their qualifying Medicare patients in 2016. Practices who see a high volume of Medicare patients can expect to report on a much larger set of patients if they choose to report individual measures. GPRO practices will report on 50% of their group’s patients versus individually by provider.
If you have been capturing PQRS data throughout the year on your Medicare patients, then you’re doing well and the manual data entry at the end of the year should be minimal. And if you haven’t been thinking about PQRS until now for fear it may give you more gray hairs, then you’ve come to the right place. It’s important to work with a registry that will work collaboratively with you to choose the best reporting plan for your group. pMD allows you to upload your patient and billing data, view your progress in a user-friendly dashboard, and easily update or add any additional data. Contact us to learn more at 415-422-9578.