Every dollar counts in the business of family medicine. That's why it's important that family physicians take time to review their 2015 Physician Quality Reporting System (PQRS) feedback reports and their 2015 Quality and Resource Use Reports (QRURs).
The 2015 reports were released by CMS on Sept. 26 and contain information that could affect physicians' payment in 2017.
Here's why. The PQRS reports spell out performance details for physicians. Physicians will learn if they satisfactorily reported to PQRS, and those who did not will receive a 2 percent cut in their 2017 Medicare payments.
The 2015 QRURs show how physician groups and solo physicians performed in 2015 on the quality and cost measures used to calculate the 2017 value-based payment modifier (VBPM).
Physicians would do well to review their reports as soon as possible. If they spot any irregularities or question a CMS calculation, they have until 11:59 p.m. EST on Nov. 30 to request an informal review(www.cms.gov) of their report.
Access Your Reports
Physicians can access their PQRS reports and their QRURs through the CMS Enterprise Portal.(portal.cms.gov) An Enterprise Identity Management (EIDM)(portal.cms.gov) account is required to obtain the 2015 reports.
Physicians with questions about their EIDM account or how to access their reports can call the QualityNet Help Desk at 866-288-8912 from 8 a.m. to 8 p.m. ET Monday through Friday, or they can email the support desk.
Physicians with questions about the 2015 PQRS Feedback Reports can review a free online user guide(www.cms.gov) CMS released on Sept. 12.
Family Practice Management has posted entries in its Getting Paid blog in recent days that address both the 2015 PQRS physician feedback reports and the 2015 QRURs.
In a Sept. 28 blog post, author Erin Solis, an AAFP regulatory compliance strategist, noted that in 2017, all solo- and group-eligible health care professionals would be subject to the VBPM.
"Payment adjustments for the VBPM depend on practice size," she wrote. "Becoming familiar with the QRUR now is important as it will continue in some form under the Medicare Access and CHIP Reauthorization Act (MACRA).
"MACRA's Merit-Based Incentive Payment System incorporates elements of PQRS and the VBPM. The initial performance period is slated to begin in 2017," she explained.
And then in a second blog post on Sept. 30, Solis urged physicians to review their 2015 PQRS feedback reports.
She noted that the reports "provide valuable information" about a physician's practice and whether a payment adjustment will be made on 2017 Medicare claims. Solis told AAFP News that "payment adjustments are made on a per-claim basis" and the correction is made automatically.
Solis said CMS began sending payment adjustment notification letters to physicians on Oct. 3.
She stressed the importance of physicians taking immediate action. "Accessing physician feedback reports now will allow you to review your performance and file an informal review before the deadline," she said.
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MACRA: The Medicare Access and CHIP Reauthorization Act
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