Transcript Document

ABCs of PQRS
Transforming Healthcare through Data-Driven
Solutions
7/18/2015
1
Welcome
• Agenda
oIntroductions
oA little about PQRS Solutions
oThe basics of PQRS
o Meaningful Use & PQRS
oQ & A
• Slides will be sent to you after the webinar
• Please ask questions along the way
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Introductions
• Thank-you to Quality Insights of Delaware
• Presenter
– Dr. Dan Mingle , CEO Mingle Analytics
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About PQRS Solutions
• Founded by Dr. Dan Mingle
o Family Physician
o Director of Ambulatory EMR at 3rd largest health system in
Maine
o Reporting PQRS since 2008
• Committed to helping practices of all sizes
o 2012 Submission Season
• Reported for over 500 eligible professionals in practices
ranging from 1 eligible professional to 250
• Qualified to submit using all methods & all
measures
o PQRS Solutions—CMS qualified Registry
o Mingle Analytics—CMS qualified Data-Submission Vendor
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2013
ABCs of PQRS
• Avoid penalties for not reporting
o If you don’t report in 2013, you will feel the adjustment
in 2015
• -1.5% of Medicare PFS
o PQRS is still mainly a ‘pay-for-reporting’ program
o Bar is low: The Quality Action must be performed just
once for each measure to qualify for incentive
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2013
ABCs of PQRS
• Be prepared for value-based purchasing
o PQRS and Meaningful Use Programs are aligning.
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Value-based purchasing is not going away
o Slowly but surely, CMS will raise the bar and pay for
performance. They want to improve outcomes
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Value-based modifier already applies to practices of 100+
Incentives are phasing out. Get in the habit of reporting now
while there is still money to be gained!
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2013
ABCs of PQRS
MU & PQRS
MU
• Attestation only
• Report on up to 9
measures
– 44 Measures available
• Small group of
professionals eligible
• All patients included
• Zero numerators and
denominators allowed
PQRS
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Must report the actual data
Several methods to report
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Claims
Registry
Data-Submission Vendor
Web-based tool
Report on only 3 measures
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Method, determines measures
available
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203 individual measures
22 measure groups
51 EHR measures
Large group of eligible professionals
Medicare only
No non-zero numerators/or
denominators
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Where to Start?
• Choose a Vendor
• Choose a Method
• Choose Measures
• Deliver your Data
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2013
ABCs of PQRS
• Can Do!
o CMS has made it easier than ever to report
o There is a submission method for
everyone
Large & small practices
All specialties
EHR or Paper
Blog Post: Almost anyone can participate in PQRS
http://thehealthcareengineer.com/blog/pqrs/almost-anyone-can-partipcate-in-pqrs
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Claims Submission
• Claims Submission is the Most
• Commonly used Method
• Cumbersome Method
• Unreliable Method
• If not Claims then … What?
Blog Post: The Problem with Claims Submission for PQRS
http://www.thehealthcareengineer.com/blog/pqrs/the-problem-with-claimssubmission-for-pqrs
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Role of the Vendor
• A reporting vendor should help you
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Decide how to report based on your specific practice
Select a method
Select measures
Be able to assist you in your data collection
Help you decide “Is it worth it?”
– Is the cost of submission greater than the incentive or
adjustment?
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Getting Started
• To consider with your reporting vendor
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How many eligible professionals in your practice?
Be sure you are counting all–
>2 can use Group Practice Reporting Option (GPRO)
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How many specialties in your practice?
Multiple specialties GRPO makes the most sense
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Do you have an EMR?
• Are you able to report from the EMR?
• If not, Measure Groups might make the most sense
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Our Approach
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Start with a consultation with decision-makers
Learn about your practice
Make top-level recommendations for reporting
approach
Depending on practice, size, specialties etc.
conduct analysis of practice management data to
determine
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Estimated incentive or penalties
Measure eligibility
Reporting method
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Pricing
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Register One Provider ($100)
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to use Measure & Incentive Advisor
Use document library to download specs and sample
documents
Register All Providers ($100 each)
– Detailed Analysis of Practice Management Data
» Projected Amount of Incentives/Adjustments
» Analysis of Measure Eligibility
Submission ($150 per registered provider)
– Pay only for those providers for whom you submit
Discounts
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Group Reporting
http://thehealthcareengineer.com/blog/pqrs/group-practicereporting-option-gpro-has-new-life-in-2013
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Q&A
How can we help you with PQRS 2013?
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Resources
PQRS Solutions website: loaded with information
www.pqrssolutions.com
Call or email PQRS Solutions:
866-359-4458
[email protected]
We are always happy to help
CMS Website:
PQRS Eligible Professionals
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/PQRS/downloads/Eligible_Professionals03-08-2011.pdf
Quality Net Help Desk
866-288-8912 [email protected]
EHR Incentive Program
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EHR Information Center
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Phone: 1-888-734-6433
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Web site: http://www.cms.gov/EHRIncentivePrograms/