Reporting Once for 2014 Medicare Quality Reporting Programs
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1 Reporting Once for 2014 Medicare Quality Reporting Programs
2 Use this tool* to learn how to report quality measures one time in 2014 in order to: Become incentive eligible for 2014 Physician Quality Reporting System (PQRS) program Avoid 2016 PQRS payment adjustment Satisfy clinical quality measure (CQM) component of Medicare Electronic Health Record (EHR) Incentive Program Start *Only applies to eligible professionals who are beyond their first year of meaningful use.
3 How do you plan to participate in PQRS in 2014? As an individual eligible professional As part of a group practice As part of a Medicare Shared Savings Program ACO As part of a Pioneer ACO
4 Q: How do you plan to participate in PQRS in 2014? A: As an individual eligible professional Must participate in PQRS as an individual (not a member of a group practice who has registered or self-nominated as a PQRS GPRO) Choose PQRS reporting option that aligns across quality programs: Directly from certified EHR technology (CEHRT) or CEHRT using a data submission vendor Qualified Clinical Data Registry (QCDR)* *Must report at least 9 ecqms from Stage 2 rule for 12-month reporting period
5 Q: Choose PQRS reporting option that aligns across quality programs A: EHR-based reporting REQUIRED: 9 measures covering at least 3 National Quality Strategy domains* 2014 REPORTING PERIOD: January 1- December 31 SUBMISSION FORMAT: QRDA I or QRDA III Satisfactorily report under PQRS for 2014? Yes *If CEHRT does not contain Medicare patient data for at least 9 measures and/or at least 3 domains, must report measures for which there is patient data. Refer to EHR Incentive Programs website for listing of measures to satisfy CQM component. No
6 Q: Choose PQRS reporting option that aligns across quality programs A: QCDR reporting REQUIRED: 9 measures covering at least 3 National Quality Strategy domains* 2014 REPORTING PERIOD: January 1- December 31 SUBMISSION FORMAT: QRDA III Satisfactorily report under PQRS for 2014? Yes *If CEHRT does not contain Medicare patient data for at least 9 measures and/or at least 3 domains, must report measures for which there is patient data. Refer to EHR Incentive Programs website for listing of measures to satisfy CQM component. No
7 Q: Satisfactorily report under PQRS for 2014? A: Yes PQRS incentive eligible for 2014 (+0.5%) Avoid 2016 PQRS payment adjustment Satisfy CQM component of Medicare EHR Incentive Program NOTE: You will still be required to report other meaningful use objectives through EHR Incentive Programs Registration and Attestation System Return to Introduction
8 Q: Satisfactorily report under PQRS for 2014? A: No Not PQRS incentive eligible for 2014 Subject to 2016 PQRS payment adjustment (-2.0%) Will not satisfy CQM component of Medicare EHR Incentive Program Return to Introduction
9 Q: How do you plan to participate in PQRS in 2014? A: Part of group practice Group practice defined as single TIN with 2 or more eligible professionals (individual NPI reassigned billing rights to TIN) What size is your group practice? 2-24 eligible professionals eligible professionals 100+ eligible professionals
10 Q: What is the size of your practice group? A: 2-24 eligible professionals Choose PQRS group practice reporting option (GPRO) that aligns across quality programs? Directly from certified EHR technology (CEHRT) CEHRT using a data submission vendor
11 Q: Choose PQRS GPRO that aligns across quality programs A: EHR-based reporting REQUIRED: 9 measures covering at least 3 National Quality Strategy domains* 2014 REPORTING PERIOD: January 1- December 31 SUBMISSION FORMAT: QRDA I or QRDA III Satisfactorily report under PQRS for 2014? Yes *If CEHRT does not contain Medicare patient data for at least 9 measures and/or at least 3 domains, must report measures for which there is patient data. Refer to EHR Incentive Programs website for listing of measures to satisfy CQM component. No
12 Q: What is the size of your practice group? A: eligible professionals Choose PQRS group practice reporting option (GPRO) that aligns across quality programs? Directly from certified EHR technology (CEHRT) or CEHRT using a data submission vendor GPRO Web Interface
13 Does your group also plan to submit Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey modules via CMS-certified survey vendor? Yes No
14 Q: Does your group also plan to submit CG-CAHPS survey modules via CMS-certified survey vendor? A: Yes REQUIRED: 6 measures covering at least 2 National Quality Strategy domains* AND all 12 CG-CAHPS summary survey modules 2014 REPORTING PERIOD: January 1- December 31 SUBMISSION FORMAT: QRDA I or QRDA III Satisfactorily report under PQRS for 2014? Yes *If CEHRT does not contain Medicare patient data for at least 6 measures and/or at least 2 domains, must report measures for which there is patient data. Refer to EHR Incentive Programs website for listing of measures to satisfy CQM component. No
15 Q: Does your group also plan to submit CG-CAHPS survey modules via CMS-certified survey vendor? A: No REQUIRED: 9 measures covering at least 3 National Quality Strategy domains* 2014 REPORTING PERIOD: January 1- December 31 SUBMISSION FORMAT: QRDA I or QRDA III Satisfactorily report under PQRS for 2014? Yes *If CEHRT does not contain Medicare patient data for at least 9 measures and/or at least 3 domains, must report measures for which there is patient data. Refer to EHR Incentive Programs website for listing of measures to satisfy CQM component. No
16 Does your group also plan to submit Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey modules via CMS-certified survey vendor? Yes No
17 Q: Does your group also plan to submit CG-CAHPS survey modules via CMS-certified survey vendor? A: Yes REQUIRED: All 22 GPRO Web Interface composite measures AND all 12 CG-CAHPS summary survey modules 2014 REPORTING PERIOD: January 1- December 31 Satisfactorily report under PQRS for 2014? Yes No
18 Q: What is the size of your practice group? A: 100+ eligible professionals Choose PQRS group practice reporting option (GPRO) that aligns across quality programs? Directly from certified EHR technology (CEHRT) or CEHRT using a data submission vendor GPRO Web Interface
19 Does your group also plan to submit Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey modules via CMS-certified survey vendor? Yes No
20 Q: Does your group also plan to submit CG-CAHPS survey modules via CMS-certified survey vendor? A: No REQUIRED: All measures included in Web Interface for pre-populated beneficiary sample 2014 REPORTING PERIOD: January 1- December 31 Satisfactorily report under PQRS for 2014? Yes No
21 Q: Choose PQRS group practice reporting option (GPRO) that aligns across quality programs A: GPRO Web Interface REQUIRED: All 22 GPRO Web Interface composite measures AND all 12 CG-CAHPS summary survey modules 2014 REPORTING PERIOD: January 1- December 31 Satisfactorily report under PQRS for 2014? Yes No
22 Q: Does your group also plan to submit CG-CAHPS survey modules via CMS-certified survey vendor? A: No REQUIRED: 9 measures covering at least 3 National Quality Strategy domains* 2014 REPORTING PERIOD: January 1- December 31 SUBMISSION FORMAT: QRDA I or QRDA III Satisfactorily report under PQRS for 2014? Yes *If CEHRT does not contain Medicare patient data for at least 9 measures and/or at least 3 domains, must report measures for which there is patient data. Refer to EHR Incentive Programs website for listing of measures to satisfy CQM component. No
23 Q: Satisfactorily report under PQRS for 2014? A: Yes PQRS incentive eligible for 2014 (+0.5%) Avoid 2016 PQRS payment adjustment Satisfy CQM component of Medicare EHR Incentive Program NOTE: You will still be required to report other meaningful use objectives through EHR Incentive Programs Registration and Attestation System Groups of will be subject to a neutral or positive VM adjustment, based on quality tiering Groups of 100+ will be subject to a negative, neutral, or positive VM adjustment, based on quality tiering Return to Introduction
24 Q: Satisfactorily report under PQRS for 2014? A: No Not PQRS incentive eligible for 2014 Subject to 2016 PQRS payment adjustment (-2.0%) Will not satisfy CQM component of Medicare EHR Incentive Program Group practices of 10+ or more will be subject to a downward VM adjustment (-2.0%) Return to Introduction
25 Q: How do you plan to participate in PQRS in 2014? A: Part of Shared Savings Program ACO ACO participants provide information to the primary TIN, the primary TIN reports information on participants behalf REQUIRED: ACO primary TIN reports all measures included in GPRO Web Interface 2014 REPORTING PERIOD: January 1- December 31 ACO primary TIN satisfactorily reports under PQRS for 2014? Yes No
26 Q: ACO primary TIN satisfactorily reports under PQRS for 2014? A: Yes Participants TINs: Are PQRS incentive eligible for 2014 (+.5%) Avoid 2016 PQRS payment adjustment Satisfy CQM component of Medicare EHR Incentive Program NOTE: You will still be required to report other meaningful use objectives through EHR Incentive Programs Registration and Attestation System Return to Introduction
27 Q: ACO primary TIN satisfactorily reports under PQRS for 2014? A: No Participants TINs: Are not PQRS incentive eligible for 2014 Are subject to 2016 PQRS payment adjustment (-2.0%) Will not satisfy CQM component of Medicare EHR Incentive Program Return to Introduction
28 Q: How do you plan to participate in PQRS in 2014? A: Part of Pioneer ACO ACO participants provide information to the primary TIN, the primary TIN reports information on participants behalf REQUIRED: ACO primary TIN reports on all measures included in the Web Interface 2014 REPORTING PERIOD: January 1- December 31 ACO primary TIN satisfactorily reports through Web Interface? Yes No
29 Q: ACO primary TIN satisfactorily reports through Web Interface? A: Yes Participants TINs: Are PQRS incentive eligible for 2014 (+0.5%) Avoid 2016 PQRS payment adjustment Satisfy CQM component of Medicare EHR Incentive Program NOTE: You will still be required to report other meaningful use objectives through EHR Incentive Programs Registration and Attestation System Return to Introduction
30 Q: ACO primary TIN satisfactorily reports through Web Interface? A: No Reporting Once for 2014 Medicare Participants TINs: Are not PQRS incentive eligible for 2014 Are subject to 2016 PQRS payment adjustment (-2.0%) Will not satisfy CQM component of Medicare EHR Incentive Program Return to Introduction
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