2014 Physician Quality Reporting System (PQRS) and QRS

Scott WeinbergSpecialist, Quality Care & Patient Access

What is PQRS?

• CMS program (Medicare only)

• Physician Quality Reporting System– Previously known as PQRI

• Provides a financial incentive to physicians who report on best practice quality measures for the Medicare patients they treat.

Why Report Quality Measures?

• Participants can receive a percentage (0.5% in 2014) of total allowed Medicare Part B charges for the 12-month period.

• Reporting quality measures in 2014 to avoid a 2.0% penalty in 2016.

Who Should Participate?

• All MD, DO, PA, NP, CNS, APRN who are reimbursed under the Medicare physician fee schedule.

• QRS is available to members and non-physician clinicians who are supervised by AAD members.

How Many Quality Measures in 2014?

To earn a 0.5% incentive and avoid a 2.0% payment reduction…

• Report at least 9 measures

• Report at least 50% of applicable patients for each measure for the full year

• Measures should cover at least 3 quality domains (done automatically through registry)

To only avoid the payment reduction…

• Report at least 3 measures

• Report at least 50% of applicable patients for each measure for the full year

• Measures should cover at least 1 quality domain (done automatically, by definition)

Quality Domains

1) Patient Safety

2) Person and Caregiver-Centered Experience and Outcomes

3) Communication and Care Coordination

4) Effective Clinical Care

5) Community/Population Health

6) Efficiency and Cost Reduction

5 Dermatology-Specific Measures (registry only)

1) Measure #137 — Melanoma: Continuity of Care — Recall System

2) Measure #138 — Melanoma: Coordination of Care

3) Measure #224 — Melanoma: Overutilization of Imaging Studies

4) Measure #265 — Biopsy Follow-Up

5) Measure #337 — Tuberculosis Prevention for Psoriasis and Psoriatic Arthritis Patients on a Biological Immune Response Modifier

8 Dermatology-Applicable Measures (included in AAD registry)

• Measure #130 — Documentation of Current Medications in the Medical Record

• Measure #131 — Pain Assessment and Follow-Up • Measure #173 — Preventive Care and Screening: Unhealthy Alcohol Use –

Screening • Measure #194 — Oncology: Cancer Stage Documented • Measure #205 — HIV/AIDS: Sexually Transmitted Disease Screening for

Chlamydia and Gonorrhea• Measure #226 — Preventive Care and Screening: Tobacco Use: Screening

and Cessation Intervention• Measure #245 — Chronic Wound Care: Use of Wound Surface Culture

Technique in Patients with Chronic Skin Ulcers (Overuse Measure)• Measure #246 — Chronic Wound Care: Use of Wet to Dry Dressings in

Patients with Chronic Skin Ulcers (Overuse Measure)

Measures with Large Denominators

• Measure #130 — Documentation of Current Medications in the Medical Record

• Measure #131 — Pain Assessment and Follow-Up

• Measure #173 — Preventive Care and Screening: Unhealthy Alcohol Use – Screening

• Measure #226 — Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

QRS (AAD Qualified Registry)

www.AAD.org/QRS

Choosing a Filing Type

Selecting Your Measures

Dashboard

User Profile

TIN & NPI

Chart Abstraction

Patient Visit Review

Validation

Important for Successfully Reporting

• Have one eligible instance for each measure• Report at least 50% of applicable

patients/visits for each measure• No measure can have 0% performance• If reporting 9 measures, select across 3

quality domains (automated in QRS)• Enter your NPI and TIN correctly into the

module

2014 QRS Timeline

Questions?

• Current QRS users: QRSSupport@healthmonix.com• General PQRS Questions: sweinberg@aad.org• CMS QualityNet Help Desk: qnetsupport@hcqis.org • AAD Member Resource Center: 866-503-7546• Visit www.aad.org/QRS to:

• Purchase the AAD QRS Registry• View online tutorials FAQ sheets• See coding specifications for reporting these measures• Latest information