PQRS is a reporting program that uses a combination of incentive payments and negative payment adjustments to promote the reporting of quality information by Eligible Professionals (EPs). Powered by HealthEC®, over 6,000 Providers have been able to successfully complete their PQRS submissions accurately and on-time. This is significant to Providers since participation in PQRS enables Eligible Professionals to avoid penalties and earn incentives on Physician Fee Schedule services that are provided to Medicare Part B Fee-for-Service (FFS) beneficiaries. In addition, participants gain the opportunity to better assess and enhance their quality of care.
Providers are able to report as individual Eligible Professionals, or can participate in the Group Practice Reporting Option (GPRO). We recommend selecting a Measures Group relevant to your practice, and then, a minimum of 20 patients who meet the group’s patient criteria must be selected. If reporting on individual measures, there are over 200 to choose from, and you must report on at least 50% of eligible Medicare Part B FFS patients or encounters for each measure. Satisfactory reporting options are provided by CMS, including determining the measure criteria, how to pass validation, and possible validation adjustments. Starting in 2015, not reporting PQRS submissions leads to a quality-based and value modifier adjustment ranging from -2% to -6% in Provider penalties from CMS.
HealthEC® partners with NJ-HITEC, a Qualified Clinical Data Registry (QCDR), to submit data to CMS. Together, we want to ensure that Providers are fully equipped to achieve meaningful use objectives to improve the quality of healthcare overall and take advantage of new financial incentives through PQRS.
For additional information, please see the article about our PQRS capabilities on EHR Intelligence:
HealthEC® is a leading Provider of knowledge, expertise and technology solutions to the healthcare industry to effectively and efficiently manage its community. Our Population Health Management platform provides the flexibility to integrate all of the critical components of a Care Management program into a single integrated platform – from patient attribution through care coordination and analytics for Payers, Providers and employers. Our experienced on-staff physicians guide healthcare organizations in the development and implementation of successful ACO programs.
The HealthEC® platform manages over 17 million patients, from more than 8,000 practices, with 12,800 physicians, and processes over 46 million claims per year. HealthEC’s vision is to enable an organization to manage their population health by aggregating information from all sources, providing expert strategy and guidance, and translating that knowledge and expertise into implementable actions that impact cost and improve quality, with clear measurable outcomes.