The Quality Game Right Now: MU and PQRS

I’m picking up where I’d left off before SAWC Spring – explaining MIPS, the Merit-Based Incentive Payment System. Although MIPS does not begin until 2017, 85% of the MIPS score is derived from performance in the 2 quality programs that clinicians should already be engaged in: Meaningful Use of an EHR (MU) and the Physician Quality Reporting System (PQRS).  The Value-Based Modifier (VBM) score is also critical, but that score is largely based on PQRS performance, which makes the choice of which quality measures to report even more important. If you are doing well with PQRS and MU, you are set to survive the transition to MIPS next year. If you have not been engaged in these programs, you still have some time to get serious about quality reporting, or plan your retirement party. February 29, 2016 was the first deadline to sign up with a specialty registry in order to meet the 2016 Meaningful Use requirement. However, the U.S. Wound Registry (USWR) is still working with providers on a case-by-case basis, particularly with those that were “actively engaged” through societies (e.g. the APMA or UHMS) or those trying to manage through interface issues with their EHR.

So call the USWR (281) 771-3627 to see if you can still meet the criteria for “active engagement.” You should already have picked the quality measures you intend to report in 2016 but it is NOT too late to do it.

USWR2015

There are ways to leverage your EHR to optimize performance in both PQRS and MU with the same effort. If you are a wound care, and/or hyperbaric medicine provider, no standard hospital EHR will enable you to pass all 9 PQRS measures and achieve all 10 MU objectives. I have explained why in previous articles, but the main reason is that it is impossible for a wound care practitioner to pass 9 PQRS measures using only the measures available from CMS. However, if you are using a standard hospital EHR, you can succeed with both PQRS and MU by downloading the wound care electronic clinical quality measures (eCQMs) available for FREE from the USWR website and inserting them into your hospital EHR:  (http://www.uswoundregistry.com/Specifications.aspx)

Transmitting the eCQMs to the USWR not only satisfies the PQRS requirements, but satisfies the requirement for specialty registry reporting under Stage 2 of Meaningful Use. There is an alternative. You can pass PQRS by reporting only the Diabetes Measure Group on 20 patients (pick one or the other of these options – either pick 9 measures from USWR or report only the Diabetes Measure Group). However, if you select the Diabetes Measure Group option for PQRS reporting, you still need some additional effort to meet the registry reporting requirement of Meaningful Use. You can do that by using your hospital EHR to transmit your patient’s Continuity of Care Documents (CCDs) to the USWR.

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Next Thursday, I’ll be talking about “Using Quality and Cost to Determine Value”


Until then,  Do the Right Thing!™

Caroline Fife, MD

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