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| Physicians listen as Billing and Coding Specialist Sherryle Givens speaks May 15, 2014, during a brown bag lunch at the USA Family Medicine Clinic. The lunch was held to thank the providers for their work on the Physicians Quality Reporting System. PQRS is a Medicare quality care initiative focused on primary care services provided to Medicare Part B Fee for Service and Railroad Beneficiaries. Beginning in 2013, reporting on select PQRS quality measures became mandatory for large group practices of 100 or more providers. |
PQRS is a Medicare quality care initiative focused on primary care services provided to Medicare Part B Fee for Service and Railroad Beneficiaries. Beginning in 2013, reporting on select PQRS quality measures became mandatory for large group practices with more than 100 providers – such as USA Physicians Group.
Implementation of quality reporting programs such as this one represent a rapidly increasing trend of insurers trying to ensure patients get high quality care. The information from this initiative in particular will be publicly reported on the Physician Compare website with the expectation that patients will be able to select a provider based on quality.
“USA Physicians Group was successful in reporting the required data for 22 measures based on Medicare services provided through our clinics for 2013,” said Sherryle Givens, coding/compliance nurse specialist at USA. “Although the reporting process was completed by the compliance department, primary clinic providers are to be applauded for their efforts to ensure the individual measures were met in their provision of quality care.”
There are more than 200 quality measures to choose from, but providers reporting as a group practice have a required subset of 22. These include:
• 12 disease-specific provision-of-care and outcome indicators focused on diabetes, hypertension, coronary artery disease, ischemic vascular disease, and heart failure;
• 2 patient safety measures - screening for fall risk and medication reconciliation following hospital discharge; and
• 8 preventive-care measures - flu and pneumococcal vaccinations and screening for breast and colorectal cancer, BMI, hypertension, tobacco use, and depression.
Due to efforts to comply with the PQRS initiative, USA Physicians Group earned a $25,000 incentive and avoided $125,000 in penalties tied to this program.
