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TOPIC: All Gain, No Pain PQRS Reporting Dec. 19 th , 2012: 1:00 p.m. – 2:00 p.m.

TOPIC: All Gain, No Pain PQRS Reporting Dec. 19 th , 2012: 1:00 p.m. – 2:00 p.m. Moderator: Stephanie Gramling, Communications Leader at Physician Sales & Service. Presented by Jim Clifford, Senior Solutions Consultant at Wellcentive. Topics of Discussion. PQRS and CMS

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TOPIC: All Gain, No Pain PQRS Reporting Dec. 19 th , 2012: 1:00 p.m. – 2:00 p.m.

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  1. TOPIC:All Gain, No Pain PQRS ReportingDec. 19th, 2012: 1:00 p.m. – 2:00 p.m. Moderator: Stephanie Gramling, Communications Leader at Physician Sales & Service Presented by Jim Clifford, Senior Solutions Consultant at Wellcentive

  2. Topics of Discussion • PQRS and CMS • Eligible Professionals • Reporting Options • Wellcentive PQRS

  3. PQRS Overview Incentive Payment Enter Patient Data Submit Registry Data

  4. In Your Office

  5. Eligible Professionals (EP)

  6. The Reporting Options

  7. Measure Group Reporting • 22 Diagnosis - Based Group Measures • Must report for at least 1 measure group • Must have a Performance Rate > 0% • The Reporting Period is January 1, 2012 – December 31, 2012 • 3 options for reporting:

  8. Measure Groups Measure Groups (22 measure groups) • Diabetes Mellitus (6 measures) • Chronic Kidney Disease (CKD) (4 measures) • Preventive Care (9 measures) • Coronary Artery Bypass Graft (CABG) (10 measures) • Rheumatoid Arthritis (6 measures) • Perioperative Care (4 Measures) • Back Pain (4 measures) • Hepatitis C (8 measures) • Heart Failure (5 measures) • Coronary Artery Disease (CAD) (4 measures) • Ischemic Vascular Disease (IVD) (5 measures) • HIV/AIDS (8 measures) • Community-Acquired Pneumonia (CAP) (4 measures) • Asthma(4 measures) • Chronic Obstructive Pulmonary Disease (COPD)(5 measures) • Inflammatory Bowel Disease (IBD) (8 measures) • Sleep Apnea (4 measures) • Dementia (9 measures) • Parkinson’s (6 measures) • Hypertension (8 measures) • Cardiovascular Disease (6 measures) • Cataracts (4 measures)

  9. Individual Measures • 208 Individual Measures • Must report on a minimum of 3 measures • Must have a Performance Rate > 0 • Eligible Professionals must report at least 80% of their Medicare Part B FFS patients during the reporting period for whom the measure applies to • The Reporting Period is January 1, 2012 – December 31, 2012

  10. The Bonus Payment • This is a Pay-for-Reporting program • Professionals that report in years 2012-2014 successfully are eligible for a 0.5% percent bonus payment for PQRS. • Potential bonus payment is calculated using total allowed charges for services furnished during the reporting period and paid under the Medicare Physician Fee Schedule. • The penalty for not reporting in 2013 is a 1.5% payment reduction in 2015 1.5% Penaltyfor not reporting in 2013/2014/2015 0.5% Incentivefor reporting 0.5% Incentivefor reporting 0.5% Incentivefor reporting

  11. Why Registry? Registry-Based Claims-Based • 2010 Success Rate: 91%* • Submit 2012 data right up until the CMS deadline in March 2013 (no need to track claims throughout the year) • Higher potential for meeting reporting criteria and receiving bonus payment • Measures and measure groups updated automatically each year as information is provided by CMS, which keeps staff from having to become measure experts 2010 Success Rate: 57%* • Must have someone in the clinic who “owns” PQRS: complete audits, know all the ins/outs, keep record of the % completed, etc. • Auditing process can be tedious and potentially a productivity loss, especially if you have a large Medicare patient population • Must complete and submit proper forms in proper format for eligible patients • No internal automated check/ balance system provided by billing company: submits only what you give them *Centers for Medicare and Medicaid Services, 2010 PQRS Reporting Experience, February 2012

  12. Why Wellcentive? • The most streamlined, reliable reporting solution available • Easy registry-based reporting - just provide data on 30 unique Medicare Part B FFS patients for a single measure group • Data verification prior to submission delivers 99% incentive eligibility • Maintain staff productivity with fast, simple reporting • Enterprise PQRS solutions available for larger organizations • A leader in PQRS reporting • Comprehensively certified by CMS since 2007 • Worked with CMS to test registry submission process in 2007 • Charter Founder Member of the CMS Registry Initiative

  13. Summary • Identify the patients for whom PQRS measures apply • Captureclinical information • Enteryour data electronically to Wellcentive or enter manually into Wellcentive PQRS data collection tool • We Submitthe data to CMS for you • Integratethe measures into your practice • Improve Quality!

  14. Thank You! For FAQs and to register please visit: www.PSS-PQRS.com The goal is improvingpatient wellness.

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