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Insights to guide your practice. 

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2015 Performance Scores Released on Physician Compare Website

by Jeff Jones, CPHP on December 21, 2016

The Centers for Medicare and Medicaid Services (CMS) has recently released new quality data on the Physician Compare website, which includes 2015 Physician Quality Reporting System (PQRS) performance scores for group practices, individual physicians and other clinicians, and Accountable Care Organizations (ACOs), as well as non-PQRS Qualified Clinical Data Registry (QCDR) data for individual clinicians. Here's what this means to your practice.

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A Simple Guide to Understanding PQRS Measures and Specifications

by Jeff Jones, CPHP on May 19, 2016

In 2016, providers are able to select from a large number of measures to submit PQRS data. However, understanding PQRS measures and specifications can be overwhelming. And since the measures you choose have a large impact on your quality and cost scores, deciding on the right measures to report should not be taken lightly. Here we will guide you through how to better understand PQRS measures and the specifications for measures.


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Topics: PQRS, Incentive Programs

The Value-Based Payment Modifier Program and It's Impact on Your Practice

by Jeff Jones, CPHP on May 4, 2016

The Value-based Modifier (VBM) provides for differential payments to a physician or group of physicians under the Medicare Physician Fee Schedule and is based upon the quality of care furnished compared to cost during a performance period. The Value Modifier program will provide comparative performance information to physicians as part of Medicare’s effort to improve the quality and efficiency of medical care. Here is how the Value Modifier program relates to PQRS and MIPS to further the movement from fee-for-service to value-based reimbursement.

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Topics: PQRS, Value-Based Reimbursement, Incentive Programs

Selecting the Right PQRS Measures: Individual vs. Measures Groups

by Jeff Jones, CPHP on May 2, 2016

Taking time to select the right PQRS measures can make a huge difference in an Eligible Providers (EP) performance in PQRS. How? Because choosing PQRS measures that align with your specialty usually makes it easier to report for the PQRS. Therefore the measure selection process should begin with a review of the entire measure list to determine which measures are important to the EP and the practice.

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Topics: PQRS, Incentive Programs

Everything You Need to Know About PQRS Reporting Methods

by Jeff Jones, CPHP on April 15, 2016

As we shift the focus from volume and profitability to patient outcomes, physicians are having to dig a litter deeper into reporting. Healthcare is shifting towards value-based reimbursement models and the Physician Quality Reporting System (PQRS) is a step in that direction. Unfortunately, at first glance, PQRS and CQM programs can be intimidating to say the least. Not only can PQRS be intimidating, but a large number of physicians believe that PQRS is time-consuming. PQRS participation rates reflect the number of providers that aren't making PQRS a priority. 

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Topics: PQRS, Incentive Programs

Understanding PQRS: What It Is and What You Need to Know Now

by Jeff Jones, CPHP on April 12, 2016

You could say Meaningful Use stole the spotlight from PQRS over the past couple of years. This could be why so many providers still have questions about the Physician Quality Reporting System. With the Merit Based Incentive Payment System (MIPS) just around the corner, PQRS isn't quite in the spotlight but it does play an important role in physician reimbursement. Now is the time to begin understanding PQRS (if you don't already) and how it will contribute to MIPS.

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Topics: PQRS, Incentive Programs

Should You Be Participating In PQRS?

by Jeff Jones, CPHP on March 29, 2016

For the first few years of PQRS, practices were eligible for incentive payments for PQRS reporting. In 2015, however, EPs that did not report on specific quality measures are facing downward adjustments to Medicare payments in 2017. Here's how you know whether you should be participating in PQRS (if you aren't already).

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Topics: PQRS, Incentive Programs

15 Things to Know About the 2016 Medicare Physician Fee Schedule

by Kaitlyn Houseman on November 12, 2015

On Friday, the Obama administration issued its final rule for the 2016 Medicare Physician Fee Schedule that includes several health IT provisions.  The fee schedule – the first since repeal of the Sustainable Growth Rate (SGR) formula and enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – includes changes to payment policies, modifications to misvalued codes, and updates to quality performance metrics under the PQRS, the Medicare Shared Savings Program, and Physician Compare, among others. (Internal Medicine News, 10/31)
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Topics: Revenue Cycle Management, Medical Business, CMS, PQRS

What PQRS Payment Adjustments Could Mean for Your Practice

by Kaitlyn Houseman on November 10, 2015

Revenue cycle management in many medical practices will soon have to take into account the Physician Quality Reporting System (PQRS). PQRS uses payment adjustments to encourage promoting of quality information by both group practices and eligible professionals (EPs).

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Topics: PQRS, Incentive Programs

What You Need to Know to Avoid a 2% PQRS Penalty

by Kaitlyn Houseman on November 4, 2015

Healthcare revenue cycle management will undergo changes in coming years as fee-for-service payment models give way to more value-based payment models. The 
Physician Quality Reporting System (PQRS) began in 2007 as an incentive-based reporting program for eligible healthcare providers to report quality data to the Centers for Medicare and Medicaid Services (CMS) through Medicare claims forms.

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Topics: PQRS, Incentive Programs

Updated 2014 Electronic Clinical Quality Measures for 2016 Reporting

by Kaitlyn Houseman on May 4, 2015

On May 1, CMS posted the annual update for the 2014 electronic clinical quality measures(eCQMs) for eligible hospitals and eligible professionals. Providers will use these updated measures to electronically report 2016 quality data for CMS quality reporting programs, including the Physician Quality Reporting System (PQRS), Inpatient Quality Reporting Program (IQR), and the EHR Incentive Programs.

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Topics: CMS, PQRS

CMS Releases 2013 PQRS and eRX Incentive Program Experience Report

by Kaitlyn Houseman on April 30, 2015

The Centers for Medicare & Medicaid Services (CMS) released the 2013 Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program Experience Report.
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Topics: CMS, PQRS

CMS Announces Extension for EPs Participating in PQRS via EHR and QCDR (QRDA III format)

by Kaitlyn Houseman on February 26, 2015

The Centers for Medicare & Medicaid Services (CMS) announced that the submission deadlines for the PQRS reporting methods below have been extended. All other submission timeframes for other PQRS reporting methods remain the same.
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Topics: CMS, PQRS

How to Report Once in 2014 for Medicare Quality Reporting Programs

by Kaitlyn Houseman on November 14, 2014

Providers participating in the 2014 PQRS program may be eligible to report their quality data one time only to earn credit for multiple Medicare quality reporting programs.

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Topics: CMS, PQRS

PQRS GPRO Registration Extended Until Friday, October 3

by Kaitlyn Houseman on October 1, 2014

The PV-PQRS registration system, initially scheduled to close on September 30, 2014, allows group practices to register to participate in the PQRS Group Practice Reporting Option (GPRO) in 2014 via Qualified PQRS Registry, EHR, or Web Interface (for groups with 25 or more eligible professionals (EPs) only). 
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Topics: CMS, PQRS

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