• What’s your Medicare quality report score? Find out here.

    Individual physicians and groups can now access the latest results of their annual Physician Feedback report and Quality and Resource Use Report (QRUR). The Centers for Medicare & Medicaid Services (CMS) released the reports on Sept. 18. They provide information on the 2016 Physician Quality Reporting System (PQRS) and the 2016 Value-based Payment Modifier (VBPM) as well as if the physician or group will receive a 2018 payment adjustment under either program.

    Physicians can access the reports through the CMS Enterprise Portal. Users must have an Enterprise Identity Management (EIDM) account with the appropriate role to access both reports. CMS has added a “Payment Adjustment and Reports Lookup” feature to the CMS Enterprise Portal this year. The tool allows representatives of group or solo physicians to look up current and prior years’ PQRS and VBPM payment adjustments as well as which feedback reports are available.

    The Physician Feedback reports will say if the individual or group met the PQRS criteria to avoid the negative payment adjustment in 2018. The QRUR provides information on physicians’ performance on quality and cost measures. Any payment adjustment under the 2018 VBPM will also be indicated on the QRUR. Both reports can be used to review performance and select measures to report under the Merit-based Incentive Payment System (MIPS).

    Physicians can request an informal review if they feel a negative payment adjustment was an error. They must apply for the informal review by Dec. 1. You can file the review through the Quality Reporting Communication Support Page. For more information or additional questions, contact the QualityNet Help Desk at qnetsupport@hcqis.org or (866) 288-8912. Physicians can find user guides to the PQRS Feedback report and QRUR online.

    CMS will send out 2018 PQRS payment adjustment notification letters at a later date. Accessing the Physician Feedback report and QRUR now will allow you to review your performance and file an informal review before the deadline.

    – Erin Solis is the Regulatory Compliance Strategist at the American Academy of Family Physicians.

    Posted on Sep 20, 2017 by Erin Solis

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.