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Physician Quality Reporting System
1. Physician Quality Reporting System: A Quick Look at the Opportunities and Pitfalls Adele Allison National Director of Government Affairs, SuccessEHS
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7. The Opportunities Potential Incentives 2011 2012 2013 2014 2015 2016 2017 PQRS Only 1.0% 0.5% 0.5% 0.5% PQRS and MOC 1.5% 1.0% 1.0% 1.0% EHR Incentive Program* Up to $18,000 Up to $12,000 Up to $8,000 Up to $4,000 Up to $2,000 Varies ePrescribing** 1.0% 1.0% 0.5%
8. The Pitfalls * Meaningful Use incentives will vary based upon year initiated and EP’s allowable charges. ** EPs cannot receive Medicare EHR Incentives and eRx Incentives, but can received Medicaid EHR Incentives and eRx Incentives. Potential Adjustments 2011 2012 2013 2014 2015 2016 2017 ePrescribing 0 -1% -1.5% -2% PQRS -1.5% -2.0% -2.0% EHR Incentive Program -1.0% -2.0% -3.0% Value Modifier TBD TBD TBD TOTAL POTENTIAL 0 -1% -1.5% -2% -2.5%⁺ -4.0%⁺ -5.0%⁺
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13. MU-PQRS Overlap PQRS Measures Description 1, 2 and 3 Diabetes Measures: A1c Poor control, LDL-C, BP (MU) 5 Heart Failure: ACE Inhibitor (MU) 7 CAD: Beta-Blocker for MI (MU) 39 Screening / Therapy Osteoporosis in Women 47 Advance Care Plan 48 Urinary Incontinence: Assessment or Absence of 110, 112 Preventive: Flu Vaccine and Mammography (MU) 111 Preventive: Pneumonia Vaccination (MU) 113 Preventive: Colorectal Cancer Screening (MU) 124 HIT Measure: EHR Adoption or Use 128 BMI: Screening and F/up (MU) 173 Preventive: Unhealthy Alcohol Use Screening 237 Blood Pressure Measure (MU) NQF 0022 Drugs to be Avoided in the Elderly NQF 0024 BMI Children Measure ages 2 through 18 (MU) 226 Preventive: Tobacco Use Measure Screening and Cessation Intervention (MU) NQF 0038 Childhood Immunization Status (MU)