CMS Physician Quality Reporting System (PQRS)

PQRS and Your Practice

PQRS

  • Pay-for-reporting, not pay-for-performance
  • Multiple ways to participate/report
  • Registry participation is the most promising path for small- and medium-sized practices
  • PQRS is not a substitute for local quality improvement efforts
  • Penalties in 2015 and beyond for those who did not successfully report two years earlier (e.g., -1.5% in 2015 if no successful reporting in 2013; -2.0% in 2016 and 2017 if no successful reporting in 2014 and 2015, respectively)
  • PQRS outcomes are partially used to calculate the value-based payment modifier
  • In 2019 and beyond, PQRS will be replaced by the merit-based incentive payment system (MIPS)

PQRS Reporting Options

  • Medicare Part B claims-based reporting (CPT II or G codes)
  • Reporting to a CMS-approved registry (PQRS Wizard(aafp.pqrswizard.com) is one option)
  • Via qualified electronic health record product
  • EHR data reporting through a qualified Physician Quality Reporting data submission vendor
  • Group practice reporting option
  • Qualified clinical data registry

Qualified Registries

A list of CMS qualified registries(www.cms.gov) is available on the CMS web site.

The American Medical Association also maintains an inventory of national clinical registries(www.ama-assn.org).

AAFP PQRS Wizard

Quality measures reporting is easy with PQRS Wizard, a simple and cost-effective online tool that collects and reports quality measures data under the CMS PQRS program.

Use PQRS Wizard to organize clinical data and to help provide evidence-based care to your patients.