QIO / Mountain Pacific
Mountain Pacific Quality Health

Physician Quality Reporting

Electronic versions of a patient's information and medical history are the next step in the continued progress to strengthen the relationship between patients and their providers. The data and the timeliness and availability of that data will improve patient care by reducing the incidence of medical error through accurate and clear records. This data will also help clinicians by reducing test duplication and treatment delays, while informing patients on how to make better personal health care decisions.

Meaningful Use
For practices working toward achieving meaningful use of electronic health records (EHRs), visit
www.cms.gov/EHRIncentivePrograms/ for information about the CMS EHR Incentive Program.

Physician Quality Reporting System (PQRS)
The 2006 Tax Relief and Health Care Act (TRHCA) requires the establishment of a quality reporting system. Physicians who satisfactorily report data on PQRS quality measures for covered services to Medicare beneficiaries can receive incentive payments.

Mountain-Pacific assists physicians and their facilities by helping to integrate the use of electronic health records (EHRs) and to report data on their quality of care. Through streamlining practices and participating in quality data reporting, health care facilities will provide better care, improve care coordination and better engage patients and their families.

For more information and resources regarding PQRS, visit the CMS website at https://www.cms.gov/PQRS/.

An Easy-to-Use Tool for Eligible Professionals
Quality Measures Crosswalk: Meaningful Use/Patient Centered Medical Home/Physician Quality Reporting

Introduction

Preface

Glossary

Quality Measures Crosswalk

Getting Started with PQRS Reporting

STEP 1: Are you eligible for the PQRS Incentive program?
Eligible providers include most physicians, podiatrists, optometrists, dentists and chiropractors, as well as practitioners and therapists.

For a complete list of eligible professionals, click here.

STEP 2: Register for an individual Authorized Access for CMS Computer Services (IACS) account, if you do not already have one.
Providers need an Individual Authorized Access for CMS Computer Services (IACS) account to view TIN-level feedback reports and to upload data for EHR-based submission.

  1. Go to https://applications.cms.hhs.gov/warning.html
  2. Enter the applications portal.
  3. Select Account Management.
  4. Select New User Registration.
  5. Select the Physician Quality Reporting Systems/eRx link.

Be sure to remember your IACS account information. See the IACS Quick Reference Guides for more information or contact the QualityNet Help Desk for assistance at 1-866-288-8912 or TTY/TDD at 1-877-715-6222 (Monday through Friday from 7:00 AM to 7:00 PM CST). You can also email for assistance at qnetsupport@sdps.org.

STEP 3: Calculate your incentive payment.
Eligible professionals will be paid 0.5% of their Medicare Part B fee-for-service (FFS) allowable charges for successfully reporting 2012 PQRS data. This payment is in addition to any incentive payments earned under the EHR Incentive Programs (i.e., Meaningful Use) or the e-Prescribe Incentive Program.

STEP 4: Determine if you are eligible for the EHR-based method to report PQRS.
If you are using a qualified EHR, you can use it to report PQRS measures to CMS instead of reporting through claims/registry. Use the qualified EHR to pull the data directly from the EHR and submit it to CMS after the close of the reporting period. Click here for the 2012 list of qualified EHRs and EHR Data Submission Vendors. The final list of qualified vendors will be posted on the CMS website (under the "Alternative Reporting Mechanisms" heading) soon.

STEP 5: If you are not eligible for EHR-based reporting, use the Registry-based or Claims-based method.

  • Registry-Based Reporting: You may be able to report through a qualified registry. A list of qualified registries for 2012 will be available later this year. The qualified registries will submit data to Medicare on your behalf after the close of the reporting period. If you elect registry reporting, contact your registry for additional instructions.
  • Claims-Based Reporting: With claims-based reporting, specific PQRS codes, called quality data codes (QDCs), must be reported on each Medicare Part B FFS eligible claim at the time it is submitted for payment.

NEXT STEPS: