2014 Physician Quality
Reporting System (PQRS) and QRS
Scott Weinberg
Specialist, Quality Care & Patient Access
What is PQRS?
• CMS program (Medicare only)
• Physician Quality Reporting System
– Previously known as PQRI
• Provides a financial incentive to physicians who
report on best practice quality measures for the
Medicare patients they treat.
Why Report Quality Measures?
• Participants can receive a percentage (0.5% in
2014) of total allowed Medicare Part B charges
for the 12-month period.
• Reporting quality measures in 2014 to avoid a
2.0% penalty in 2016.
Who Should Participate?
• All MD, DO, PA, NP, CNS, APRN who are
reimbursed under the Medicare physician
fee schedule.
• QRS is available to members and nonphysician clinicians who are supervised by
AAD members.
How Many Quality Measures in 2014?
To earn a 0.5% incentive and
avoid a 2.0% payment
reduction…
To only avoid the payment
reduction…
• Report at least 3 measures
• Report at least 9
measures
• Report at least 50% of
• Report at least 50% of
applicable patients for each
applicable patients for
measure for the full year
each measure for the full
year
• Measures should cover at • Measures should cover at
least 3 quality domains
least 1 quality domain (done
(done automatically
automatically, by definition)
through registry)
Quality Domains
1) Patient Safety
2) Person and Caregiver-Centered
Experience and Outcomes
3) Communication and Care Coordination
4) Effective Clinical Care
5) Community/Population Health
6) Efficiency and Cost Reduction
5 Dermatology-Specific Measures
(registry only)
1) Measure #137 — Melanoma: Continuity of Care
— Recall System
2) Measure #138 — Melanoma: Coordination of
Care
3) Measure #224 — Melanoma: Overutilization of
Imaging Studies
4) Measure #265 — Biopsy Follow-Up
5) Measure #337 — Tuberculosis Prevention for
Psoriasis and Psoriatic Arthritis Patients on a
Biological Immune Response Modifier
8 Dermatology-Applicable Measures
(included in AAD registry)
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Measure #130 — Documentation of Current Medications in the Medical
Record
Measure #131 — Pain Assessment and Follow-Up
Measure #173 — Preventive Care and Screening: Unhealthy Alcohol Use –
Screening
Measure #194 — Oncology: Cancer Stage Documented
Measure #205 — HIV/AIDS: Sexually Transmitted Disease Screening for
Chlamydia and Gonorrhea
Measure #226 — Preventive Care and Screening: Tobacco Use: Screening
and Cessation Intervention
Measure #245 — Chronic Wound Care: Use of Wound Surface Culture
Technique in Patients with Chronic Skin Ulcers (Overuse Measure)
Measure #246 — Chronic Wound Care: Use of Wet to Dry Dressings in
Patients with Chronic Skin Ulcers (Overuse Measure)
Measures with Large Denominators
• Measure #130 — Documentation of Current
Medications in the Medical Record
• Measure #131 — Pain Assessment and Follow-Up
• Measure #173 — Preventive Care and Screening:
Unhealthy Alcohol Use – Screening
• Measure #226 — Preventive Care and Screening:
Tobacco Use: Screening and Cessation
Intervention
QRS (AAD Qualified Registry)
www.AAD.org/QRS
Choosing a Filing Type
Selecting Your Measures
Dashboard
User Profile
TIN & NPI
Chart Abstraction
Patient Visit Review
Validation
Important for Successfully Reporting
• Have one eligible instance for each measure
• Report at least 50% of applicable
patients/visits for each measure
• No measure can have 0% performance
• If reporting 9 measures, select across 3
quality domains (automated in QRS)
• Enter your NPI and TIN correctly into the
module
2014 QRS Timeline
Academy to close purchase in
December 12, 2014; January 16, 2015 is
last day to submit data
In early 2015, validation of all submitted
information occurs
If issues with your data arise, you will
be contacted to try and remedy
Registry submits all data to CMS in
February 2015
Practices should expect a payment in
fall 2015
Questions?
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Current QRS users: QRSSupport@healthmonix.com
General PQRS Questions: sweinberg@aad.org
CMS QualityNet Help Desk: qnetsupport@hcqis.org
AAD Member Resource Center: 866-503-7546
Visit www.aad.org/QRS to:
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Purchase the AAD QRS Registry
View online tutorials FAQ sheets
See coding specifications for reporting these measures
Latest information