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PQRS 2013

PQRS 2013. PQRS. PQRS Reporting: Getting Started. Getting Started. Getting Started: Measure Selection. Decide which measures best fit for your Medicare population Choose 3 or more applicable individual measures OR the group measure What conditions do you usually treat?

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PQRS 2013

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  1. PQRS 2013

  2. PQRS

  3. PQRS Reporting: Getting Started

  4. Getting Started

  5. Getting Started: Measure Selection • Decide which measures best fit for your Medicare population • Choose 3 or more applicable individual measures OR the group measure • What conditions do you usually treat? • What types of care or interventions are provided in the clinic? • Information on the measures is under the 2013 PQRS Measure Details section of the webpage: www.apta.org/PQRS

  6. Measure Type: Individual vs Group

  7. Getting Started: Reporting Method and Participation • Choose a reporting method • Claims versus registry • Talk to you billing provider • Qualified registries https://www.cms.gov/PQRS/20_AlternativeReportingMechanisms.asp • Choose reporting participation • Individual versus group (GPRO)

  8. Reporting Method Claims vs Registry

  9. Reporting Participation: Individual vs GPRO

  10. Getting Started: Staff Education • Educate staff about the measure specifications and billing procedures • Create processes that support PQRS implementation • Flow charts or algorithms for clinicians • AMA tool for 2013 updates typically posted by February http://www.ama-assn.org/ama/pub/physician-resources/clinical-practice-improvement/clinical-quality/physician-quality-reporting-system-2012.page • Checklists for billing staff

  11. Getting Started: Auditing Your Success • Plan an auditing process to evaluate your success • Billing audit for claims submission • Use billing data and N365 remittance advice code on EOB • Quality Net quarterly dashboard reports • Registry feedback reports • Chart review for content • Documentation must support the clinical quality action as indicated by the chosen QDC

  12. PQRS Reporting: Case Examples

  13. PQRS Process Interim Quarterly Dashboard Reports PQRS Audit Final 2013 Feedback Report- Fall 2014 Source: CMS Open Door Forum 3/22/2011

  14. Case Example: Individual Measures

  15. Case Example: Measure #130

  16. Case Example: Measure #131

  17. Case Example: Measure #154

  18. Case Example: Measure #155

  19. Case Example: Individual Measures

  20. Additional Resources • APTA: • Case studies • Podcasts on specific measures • Successful reporting requirements

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