DC2 Healthcare and the Physician Quality Reporting System
The Centers for Medicare & Medicaid Services (CMS) continuously seeks ways to improve healthcare quality as guided by the CMS Quality Strategy1. Most recently is moving from a purely fee-for-service (FFS) payment system to payment models that reward providers based on the quality and cost of care provided as reported through the Physician Quality Reporting System (PQRS) – established in 2006 – as a CMS quality reporting program. These rewards originally provided payment incentives to Medicare providers who reported quality performance measures. Starting with the 2015 reporting year, penalties will be assessed to providers who fail to report will receive a downward payment adjustment in 2017. Participation in the program involves the reporting of designated administrative codes on billing claims, through a certified electronic health record (EHR), or qualified PQRS registry such as DC2 Healthcare.
To learn more about the CMS Quality Strategy, and to provide feedback and public comment, please click on the following link: CMS Quality Strategy
What is PQRS?
Physician’s Quality Reporting System
- Reporting program that promotes reporting of quality information by eligible professionals (EPs).
- EPs report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries
- Currently EPs can earn incentive payments
Starting in 2016 payment adjustments will be applied to EPs who do not satisfactorily report data (based on 2014 reporting)
Current Year’s Performance Measures
The DC2 Healthcare offers full PQRS program reporting services of all 260 individual PQRS measures and 21 measure groups available for reporting. We streamline and simplify existing quality programs to reduce healthcare professionals’ participation burden by:
- Automation of health record data entry directly to our PQRS metrics collection database as simply printing the document
- Our research team includes data entry staff with QA validation and verification procedures
- Through participation in our research studies we integrate data points already collected for analytical comparative benchmarks reporting
- Guidance and assistance to define your easiest path to reporting
- Our online physicians portal provides an easy-to-use system fully customizable to your specialty
- Our online physicians portal provides additional comparative and quantitative metrics reporting with state and national measures
Financial Risks and Rewards
- Groups with 2-9 EPs and solo practitioners: automatic -2.0% of MPFS downward adjustment
- Groups with 10+ EPs: Automatic -4.0% of MPFS downward adjustment
To avoid a penalty in 2017, physicians must report on one measure group, or at least 9 individual measures which encompass 3 of the 10 National Quality Strategy domains, applicable to their practice for at least 50% of their eligible patients between Jan. 1 and Dec. 31, 2015.
How To Get Started
For Step-by-Step Instruction in Getting Started with the Physician Quality Reporting System (PQRS) contact us at:
- Telephone: 615-712-9574
- Fax: 615-730-8475