Transcript NACOR Introduction to Qualified Clinical Data Registries

NATIONAL ANESTHESIA
CLINICAL OUTCOMES
REGISTRY (NACOR)
July 15, 2014
PQRS Incentive/Penalty Amounts*
Successful PQRS
Participation
PQRS+MOC
2013
0.5%
1.0%
2014
0.5%
1.0%
Not Participating
Successfully in PQRS
-1.5% (in 2015)
-2.0% (in 2016)
2015
2016
2017
No PQRS Incentive,
Potential +% with Value
Modifier
*% of Total Allowable Medicare Part B FFS Charges
-2.0% (based on
2014 reporting
-2.0% (based on
2015 reporting)
VALUE MODIFIER INCENTIVE/PENALTY
Performance
year
VM Year
Physician Group
Size
Possible VM Outcomes
•
2013
2015
100+ EPs
•
•
100+EPs
•
•
•
2014
2016
10+EPs
•
•
•
2015
2017
ALL INDIVIDUAL
PHYSICIANS
•
•
•
VM -2.0% penalty (no
PQRS)
0%
Up to +2.0x incentive
(budget neutral)
-2.0% penalty (no
PQRS or low score)
0%
Up to 2.0x incentive
(budget neutral)
VM -2.0% penalty (no
PQRS)
0%
Up to +2.0x (budget
neutral)
Penalty % TBD (no
PQRS or low score)
0%
Incentive % TBD
Increase reporting requirements
 Emphasis on National Quality Strategy domains

 New Qualified Clinical Data Registry (QCDR)
option
EHR reporting option ok for GPROs
 Measures groups registry-only reporting
 Measures applicability validation for registry
 Eliminate Administrative Claims option

CMS-approved entity that collects clinical data for patient/disease
tracking for quality improvement
 QCDRs are typically specialty society registries like AQI’s National
Anesthesia Clinical Outcomes Registry (NACOR)
 Measure data across multiple payers, not limited to Medicare
beneficiaries
 Allowed to report “non-PQRS” and PQRS measures for successful
PQRS reporting



Greater potential to meet the 9/3 reporting
requirements; increasing strictness with other
reporting mechanisms.
Meeting multiple requirements/needs:




PQRS participation
Maintenance of certification part IV
Quality improvement
Support better outcome under the Value Modifier
program; using a QCDR, quality scores:



Are easier to monitor and improve throughout the reporting
year
Could be higher because of the frequent
feedback/monitoring
Greater choice of measures to report=potential higher
quality scores.
PQRS Requirements for Individual EPs
Gain the 2014 PQRS Incentive
(0.5%)
Avoid the 2014 PQRS Payment
Adjustment (-2.0%)
NEW:
Qualified
Clinical Data
Registry
(QCDR)
•
Report 9 measures across 3 NQS •
domains for 50% of all applicable
cases (at least one “outcome”
measure)
Traditional
Qualified
Registry
•
Report 9 measures across 3 NQS
domains for 50% of applicable
Medicare Part B FFS cases
OR
If < 9 measures apply, report 18 measures for 1+ NQS
domains, subject to the
Measures Applicability Validation
(MAV) process
•
Report 3 measures across
at least 1 NQS domain for
50% of all applicable cases
(at least one “outcome”
measure
Be 2014 PQRS incentive
eligible
OR
• Report ≥ 3 measures for at
least 50% of applicable
Medicare Part B FFS
patients
OR
• If < 3 measures apply,
report 1-2 for 1+ NQS
domains, subject to the
Measures Applicability
Validation (MAV) process
•
National Anesthesia Clinical Outcomes
Registry (NACOR)
NACOR is a clinical data registry approved by CMS as a QCDR
for the 2014 PQRS program.
ASA and AQI collaborated in developing the measures to be
included
Proposed Measures
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