Physician Quality Reporting Systems has been a voluntary federal program since 2007 offering financial incentives for physicians that measure and report quality data to CMS. However, reporting will be mandatory in 2015 for providers to treat CMS patients, and those who fail to report will receive penalties.
The Hart Health Strategies and American Association of Neurological Surgeons released a report for neurosurgeons about PQRS next year. Here are 10 things to know:
1. Surgeons are required to report on the previous year, so those who do not satisfy PQRS in 2014 are subject to penalties in 2016.
2. Going forward, PQRS data will be used in combination with cost-of-care data to calculate performance-based payment adjustments — the Value-Based Payment Modifier. Practices with 10 or more eligible professionals that don't satisfy PQRS requirements this year could be subject to -2 percent payment adjustments under VBM, meaning they'd have a -4 percent payment adjustment in 2016.
3. Eligible professionals choose from several reporting options to satisfy PQRS requirements. They can report as an individual physician or group practice. The NeuroPoint Alliance's National Neurosurgery Outcomes Database may qualify for 2014 PQRS incentives and avoid 2016 penalties.
4. Surgeons can report data with claims, qualified registries, qualified electronic health records, web interface or qualified clinical data registries. The number of measures necessary to qualify changes based on the reporting method.
5. CMS offered less rigorous reporting requirements this year for physicians who only wished to avoid penalties. Physicians who complete only these less rigorous potions will not receive the 2014 PQRS incentive.
6. The new reporting option for 2014 is Clinical Qualified Data Registries, which allow physicians to report on non-PQRS measures collected in specialty society registries. NPA is not currently a QCDR, but prepares to become one in the future.
7. Make sure your preferred reporting method can report a sufficient number of measures applicable to your practice. There is currently a lack of performance measures with sufficient granularity neurosurgery, and AANS/CNS along with other groups is advocating for change.
8. Individuals are not able to register for 2014 PQRS participation.
9. Group practices who wanted to report for PQRS GPRO for 2014 were required to register by Sept. 30. These eligible professionals and groups could receive an additional 0.5 percent incentive payment for participating in the qualified Maintenance Certification Program.
10. The potentially relevant PQRS measures for neurosurgeons include:
• Osteoporosis: Communication with physician managing on-going care post-fracture of hip, spine or distal radius for men and women aged 50 years and older
• Osteoporosis: Management following fracture of hip, spine or distal radius for men and women aged 50 or older
• Osteoporosis: Pharmacologic therapy for men and women aged 50 years and older
• Screening or therapy for osteoporosis for women aged 65 years or older
• Osteoarthritis: Function and pain assessment
• Stroke and stroke rehabilitation: Venous thromboembolism prophylaxis for ischemic stroke or intracranial hemorrhage
• Stroke and stroke rehabilitation: Discharged on anti-thrombotic therapy
Click here for additional measures related to stroke, radiology, low back pain imaging studies, epilepsy, oncology, antibiotics and urinary issues, among other measures.