Many physicians are wondering whether PQRS is worth the trouble of tracking and reporting the data required. After all, a 2% penalty doesn’t seem like very much.
However, setting aside the fact that the 2% penalty could mean a loss of $5,000 of 2016 Medicare payment to the average practice, there is another consideration.
This other consideration is your listing on the Physician Compare site developed and promoted by CMS, and it became a bigger issue recently when CMS began including PQRS data on the site. Right now PQRS data is only listed for 141 accountable care organizations (ACOs) and 66 group practices, but the plan is to include this data in individual providers’ listings in 2015.
This means that consumers—potential patients—will be able to see information such as the rate at which clinicians in these organizations prescribe aspirin to patients with diabetes and ischemic vascular disease.
It also raises the question of what consumers will think when they see these ratings; critics say that the information can be misleading for Medicare beneficiaries. Many feel that the measures are too few and overly focused on diabetes, the data is dated, and the scores may reflect poor documentation rather than poor patient care.
Up until last month, Physician Compare published only the type of data that physicians published on their own websites: training, board certification, contact information, hospital affiliation, and whether they accepted Medicare assignment.
During a Town Hall meeting held by CMS on Feb. 24 to hear feedback on the revised site, many healthcare organizations gave critical feedback, with comments ranging from the fact that the data is outdated and, according to several speakers, incorrect. A representative from the College of Pathologists said that members of that organization had found that 50% of the entries were incorrect, particularly those related to PQRS, and said that “Accuracy must be of primary importance.”
Koryn Rubin, Assistant Director, Federal Affairs at the American Medical Association, reported that AMA members have found that it can take up to 4 months to correct a profile, which was of significant concern to the organization and its members. Rubin also expressed the organization’s disappointment with CMS’ rollout of the new information, particularly the “star” rating format.
“The AMA continues to caution CMS on its development and rollout of Physician Compare,” Rubin stated.
Other organizations expressing their concerns included the American Association of Orthopaedic Surgeons, American Association of Neurological Surgeons, Pew Research Center, American Medical Group Association, and American Academy of Ophthalmology.
Jerry Penso, MD, chief medical and quality officer for the American Medical Group Association (AMGA), which represents some of the nation’s largest group practices, said “For year one, I would take any use of the numbers and comparisons with a big grain of salt.”
We hope that CMS will address these issues, as all signs are that the PQRS data will be a factor on the Physician Compare site. And that means that PQRS is on its way to becoming more than just another incentive/penalty program from CMS. Data quality issues aside, if consumers compare a practice that has PQRS data vs. one that doesn’t, it seems likely that they will be swayed to choose a practice that is participating in a “quality program.”
To protect your practice, it seems advisable to participate in PQRS for 2014. The best way is to look for an EHR vendor that has been approved for all 64 EHR CQMs and one that has a Health Maintenance reminder system that prompts the provider to perform preventive measures at the point of care. The best way to manage clinical quality is to advise patients when they are in the exam room and not via a letter or phone call. The good news: MediTouch makes it easy; creating PQRS-compliant files is as simple as performing basic Health Maintenance and Preventive Care in our EHR.
For more information on PQRS and how you can successfully participate, get our free Insider’s Guide to Getting Paid for Meaningful Use and PQRS in 2014.