QUALITY TODAY

A blog dedicated to advancing healthcare quality.

How to Use Your Annual QRUR and PQRS Feedback Reports for Improvement

Posted by Jennifer Wilbers, MHA, ARM-E, AIT, CHES, EMT-P on Aug 30, 2016 10:00:00 AM

Prepare for the release of Physician Quality Reporting System (PQRS) reports and Qualtiy and Resource Use Reports (QRUR), which provide important information on payment adjustments for 2017 and improvement opportunities. They will be released by CMS any day now.

PQRS feedback reports depict your program year 2015 PQRS reporting results, including payment adjustment assessment for 2017.

QRURs are how a practice obtains comparative information about the quality and cost of the care provided to Medicare patients. QRURs should be used to:

  • Verify the accuracy of EPs billing under your group’s Tax Identification Number (TIN).
  • Examine the number of patients attributed to your group and the basis for the attribution.
  • Evaluate how your group’s performance compares to other groups and which attributed beneficiaries are driving your group’s cost and quality measures.
  • Show how providers will fare under the 2017 Value-Based Modifier (VM)
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Topics: value-based care, value-based payment modifier, PQRS, quality improvement, QRUR

3 Value-Based Care Questions for Nursing Homes

Posted by Revee White on Apr 28, 2016 10:00:00 AM

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At Primaris, we talk to nursing homes and other care providers around the country and we know organizations have a lot of questions about value-based payments. Here is a quick look at three questions we’re frequently asked by nursing homes about value-based payments and our services:

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Topics: value-based care, nursing homes, value-based payment modifier

2015 Mid-Year QRUR Reports Available Now!

Posted by Rachel Verslues on Apr 21, 2016 10:00:00 AM

The Centers for Medicare and Medicaid Services (CMS) has released the 2015 Mid-Year Quality and Resource Use Reports (MY-QRURs). 2015 marks the first year CMS is distributing these reports to groups and solo practitioners nationwide.

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Topics: operational efficiency, value-based care, value-based payment modifier, PQRS, quality improvement, QRUR

2016 PQRS GPRO Registration Now Open: Five Steps You Can Take to Prepare

Posted by Revee White on Apr 12, 2016 10:00:00 AM

Registration is now open to self-nominate your group for GPRO for 2016 PQRS reporting.  You must select the method of reporting you plan to use, so please decide this prior to registering.  Registration is open from April 1 through June 30.  Complete information is now available  on the registration page.

GPROs may report using the GPRO Web Interface, EHR-Direct/Data Submission Vendor, Qualified Registry or Qualified Clinical Data Registry.  If your group (TIN) has 100 or more providers, you must report CAHPS for PQRS.  Groups of 2-99 MAY elect to report CAHPS, if they desire. 

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Topics: value-based care, value-based payment modifier, GPRO, PQRS, chart abstraction, abstraction vendor

Are you ready for 2016 PQRS reporting?

Posted by Sandy Pogones on Feb 9, 2016 10:00:00 AM

Next_Steps.jpgIt can't be time to turn our attention to 2016 PQRS reporting. If you're like us, you're knee deep in 2015 reporting and abstraction right now. However, now is the time to make plans for 2016 PQRS reporting

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Topics: value-based payment modifier, GPRO, PQRS

What the CMS benchmarks mean for 2017 Value Modifier calculation

Posted by Sandy Pogones on Jan 11, 2016 10:00:00 AM

The Centers for Medicare & Medicaid Services (CMS) released the performance benchmarks for quality measures that will be part of the Value Modifier calculation for 2017 (see announcement below). 

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Topics: value-based care, value-based payment modifier, GPRO, PQRS, abstraction vendor, value modifier

19 Ways to Value-Based Payment Success

Posted by Kellyn Freeman on Oct 29, 2015 10:00:00 AM

Resistance is a natural human reaction to change. But in situations where change is inevitable, resisting it is futile. Learning to embrace new ways of doing things can lead to progress. Right now the healthcare industry is trying to adjust to major changes brought on by the movement to value-based payments. While the transition to value-based care brings challenges, there are also opportunities for the physicians, hospitals and other healthcare providers that are able to adapt to new payment models.

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Topics: value-based care, value-based payment modifier

How to Use Your 2014 Annual QRUR for Improvement

Posted by Revee White on Oct 12, 2015 3:18:00 PM

Quality and Resource Use Reports, or QRURs, are how a practice obtains comparative information about the quality and cost of the care provided to Medicare patients. QRURs should be used to:

  • Verify the accuracy of EPs billing under your group’s Tax Identification Number (TIN).
  • Examine the number of patients attributed to your group and the basis for the attribution.
  • Evaluate how your group’s performance compares to other groups and which attributed beneficiaries are driving your group’s cost and quality measures.
  • Show how providers would fare under the policies finalized for the 2016 Value-Based Modifier (VM)
Read More

Topics: value-based care, value-based payment modifier, PQRS, quality improvement, QRUR

The MACRA Lowdown

Posted by Kara Calton on Aug 4, 2015 2:30:00 PM

On April 16th, President Obama signed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) into law.  MACRA effectively repeals the sustainable growth rate (SGR), and continues the federal government’s emphasis on incentivizing provider’s transitions from volume-based payment models to value-based models.

On July 1st, 2015, clinicians will begin receiving an annual 0.5 percent payment increase to Medicare payments.  These payments will continue through December 31st, 2018 in efforts to support a predictable transition from fee-for-service to quality-based payment.   As of January 1st, 2019, clinicians will have a choice between two payment pathways including the new Merit-based Incentive Payment System (MIPS) or an Alternative Payment Model (APM).  

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Topics: value-based payment modifier, macra

Primaris CEO featured in Healthcare Finance News

Posted by Kellyn Freeman on Jun 1, 2015 1:23:00 PM

Primaris CEO Richard A. Royer was featured today in Healthcare Finance News on "5 Steps to a Better Payment Methodology.

Here's an excerpt from that article:   

"Healthcare executives are well aware that both government agencies and private insurers are moving away from the fee-for-services model and towards a value-based payment methodology. Stakeholders currently using a mix of value-based remibusement and fee-for-service models project that payment with some form of value measurement will make up two-thirds of the market by 2020. That’s up from one-third today, according to The 2014 State of Value-Based Reminbursement, an independent research study of 464 payers and providers that was released last year."

Read the full artice in Healthcare Finance News

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Topics: care coordination, value-based payment modifier, news, healthcare finance, fee-for-service

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