Physician Quality Reporting System (PQRS)
Physician Quality Reporting System (PQRS – Formerly known as the Physician Quality Reporting Initiative or PQRI) – Established by the Centers for Medicare & Medicaid Services (CMS), PQRS uses a combination of incentive payments and downward payment adjustments (penalties) to promote reporting of quality information by eligible professionals. However, the financial incentive (available to eligible professionals who satisfactorily report data on certain quality measures for Medicare Part B services paid under the physician fee schedule) will sunset after 2014. Additionally, CMS is mandated to apply a payment adjustment (penalty) beginning in 2015 (based on data reported in 2013) to those eligible professionals who do not satisfactorily report (or do not report) data on quality measures for covered professional services. This annual assessment will continue indefinitely, using data from the calendar year two years prior. That is, the payment adjustment (penalty) in 2016 is based on reporting year 2014.
- Mastering the Basics of PQRS (PQRS Instructional Materials) – Updated for 2014, this online tutorial (available to AUA members only) will assist urologists and members of their care team to understand and carry out the mechanics of PQRS reporting. If you are new to PQRS, the detailed material will help you get started by explaining reporting options and recommended measures among other features; if you have reported previously, this will help improve your reporting. You may move through the information at your own pace and return as often as you need. Take the short module quizzes to test your knowledge of what you have learned and ensure that you successfully report.
- PQRS Toolkit
- PQRS Instructional Materials – CMS provides a series of free items to increase your understanding of PQRS and your likelihood to succeed. Continuing education credits are available for each course.
- The CMS Physician Quality Reporting System (PQRS) Program: What Medicare Eligible Professionals Need to Know in 2014 – This Web-based training course is designed to provide an overview of the PQRS requirements so that all eligible professionals can earn the 2014 incentive for successfully participating in the program, as well as avoiding the payment adjustment in 2016 for not reporting this year.
- Quality Measurement 101 – This beginner module provides the basics of quality reporting, specifically for PQRS.
- 2014 PQRS Reporting Requirements – Use this intermediate module to learn the steps to satisfactory report and earn an incentive for the 2014 PQRS program. The module also walks you through the steps on how to avoid the 2016 PQRS payment adjustment as well as explain the 2016 value modifier (VM) adjustment.
- How to Report Once for 2014 Medicare Quality Reporting Programs – This advanced module explains how to report quality measures one time during the 2014 program year and satisfy quality reporting requirements for several Medicare quality reporting programs. These programs include PQRS, the Medicare Electronic Health Record (EHR) incentive program, the value-based payment modifier (VM), and Accountable Care Organizations.
- Measure-Applicability Validation Course – For those unable to report the required number of PQRS measures (currently nine to earn the incentive and three to avoid the PQRS penalty), the Measure-Applicability Validation (MAV) process is applied. Through the MAV, CMS determines whether individual eligible professionals (EPs) or group practices have satisfactorily participated in PQRS to the best of their ability. Walk through this online course to learn more about the process and see if the MAV process applies to you.
- PQRSwizard – Learn how this instructional webinar will help you get started. If you are an American Urological Association (AUA) member or a Practice Managers’ Network subscriber, you can log in to the group discount programs page to sign up and start using this valuable tool today. If you are not an AUA member, learn how to join and access this useful registry tool!
- AUA Comment Letter on Core Measure Set for Urologists April 16, 2014 | PDF
- AUA Recommended Measures for Measure Core Set April 16, 2014 | Excel
- Value-Based Payment Modifier – The Value Based Payment Modifier (VM) is a quality program, currently affecting group practices of ten or more providers, that is based on cost and quality. The VM program utilizes reported PQRS data along with other information collected and assessed by CMS to either reward or penalize physicians for the quality and cost of care provided.