This year, Medicare begins to financially penalize clinicians who fail to succeed with quality programs. We are all in this together! The two critical programs are the Physician Quality Reporting System (PQRS) and the Meaningful Use (MU) of an Electronic Health Record (EHR). You could lose as much as 9% of your Medicare revenue. Penalties will continue to increase under MACRA, the Medicare Access and CHIP Reauthorization Act of 2015. CMS hopes this program will reward “better” care rather than just “more” care.
MACRA creates a new quality system to determine physician payment called MIPS, the Merit-Based Incentive Payment System. MIPS combine parts of the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program into one big, high-stakes program. You MUST succeed with PQRS and MU to survive in clinical practice. It is important to remember that everyone’s MIPS score and their performance on each quality measure will be publicly available on the Physician Compare website. Patients and private payers will be able to see your performance rated on a scale of 0 to 100 compared to all the other clinicians in the country who reported those same quality measures. That is the reason why reporting measures that are not relevant to your specialty just to “pass” PQRS is not a good long term strategy!
Meaningful Use (MU) of an EHR requires that you submit data to a specialty registry (Objective 10). The US Wound Registry (USWR) is recognized as a specialty registry for Wound Care, Hyperbaric Medicine and Podiatry. You have until February 29, 2016 to sign up with the USWR in order to achieve Objective 10.
You can succeed with PQRS by reporting the Diabetes Measures Group on only 20 patients. Reporting the Diabetes Measure Group is NOT a good long term strategy to survive MIPS but it will get you through PQRS this year. The USWR can submit your PQRS data. Going forward, the USWR has wound care specific measures you can download and install into your EHR. That’s how to succeed long-term with MIPS.
Caroline Fife, MD
I’ve got a NEW Facebook Page – be sure to follow me there too!