Making Sense of MACRA: Using Data to Prepare


QRURs display the scores for the quality and cost of care you provide Medicare patients. Use your QRUR to discover practice improvements that maximize payments, both now and when MACRA begins.

Fam Pract Manag. 2016 Sep-Oct;23(5):41-46.

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Each year, the Centers for Medicare & Medicaid Services (CMS) generates Quality and Resource Use Reports (QRURs) that assess the quality and cost of care you provide to Medicare Part B beneficiaries. This report serves as your Medicare “report card.” It scores performance in two Medicare quality programs.

The QRUR includes performance information about PQRS quality measures, claims-based outcome measures, and claims-based cost measures. CMS uses that information to compare your performance to that of your peers. Data in the QRUR is used to calculate your Value Modifier (VM) and assign payment adjustments (positive, negative, or neutral) in the VBPM program.

If you're not reporting to Medicare quality programs, your Medicare physician fee schedule (PFS) payments can be reduced by up to 9 percent (2 percent for PQRS, up to 4 percent for the VBPM, and 3 percent for meaningful use). Reviewing your practice's QRUR gives you information that can help your practice optimize payments now and in the future. This insert provides an overview of the QRUR, including information about the types of reports, how to access your practice's QRUR, examples of tables (called “exhibits”) in the annual QRUR, and what the reports mean to your practice.


Copyright © 2016 by the American Academy of Family Physicians.
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