Report PQRS Measures Via Claims? See Your 1st Quarter 2014 Results

The Centers for Medicare & Medicaid Services (CMS) is providing individual eligible professionals (EPs) who participate in the Physician Quality Reporting System (PQRS) via the claims reporting option an opportunity to review their quality data through a web Dashboard. The Dashboard will allow EPs to monitor their claims-based measures and determine if they are meeting PQRS reporting requirements. CMS has provided a Dashboard User Guide and Quick Reference Guides to help you retrieve and review your data.

To view quality data, EPs (anesthesiologists and others physicians and practitioners paid under the Medicare Physician Fee Schedule) must have reported at least one PQRS quality measure sometime between January and March of this year. Anesthesia care measures that most members would report include PQRS Measures #30 (Prophylactic Antibiotic Administration), #44 (Preoperative Beta-Blocker in Patients with Isolated CABG Surgery), #76 (Central Venous Catheter Insertion Protocol) or #193 (Perioperative Temperature Management).

PQRS is a voluntary reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs). For the 2014 reporting period, PQRS includes incentive payments of 0.5% for satisfactory reporting and payment adjustments of 2% for unsatisfactory reporting. The value-based payment modifier (VM) also includes the potential for incentive payments and payment adjustments and is based on data reported under PQRS. In 2012, more than 28,000 anesthesiologists participated in PQRS and nearly 80% of them were eligible for the payment incentive.

It’s not too late to participate in PQRS for 2014 and there are several reporting options that anesthesiologists can use to meet program requirements. Anesthesiologists are encouraged to explore the Qualified Clinical Data Registry option that allows for reporting specialty-specific non-PQRS quality measures in addition to the four measures noted above. The Anesthesia Quality Institute (AQI) National Anesthesia Clinical Outcomes Registry (NACOR) is a CMS-Approved QCDR.

For information on PQRS, please visit the ASA Frequently Asked Questions page or contact the ASA Quality and Regulatory Affairs (QRA) Department at (202) 289-2222 or at [email protected].