Option 1: IRIS™ (Intelligent Research in Sight) Registry EHR System Integration
Academy members with EHR can have the Academy's IRIS Registry integrate with their EHR system to extract data needed to report clinical quality measures for PQRS, which can also meet the CQM requirements for 2015 EHR Meaningful Use Incentive Program, as well as Stage 2 Menu Measure 6 (specialized registry).
Report nine clinical quality measures across three quality domains. If your EHR does not contain patient data for nine measures covering three domains, then report all of the measures for which there is Medicare Part B patient data. Physicians are required to report on at least one measure for which there is Medicare Part B data.
- No manual data entry
- Simultaneously reports for both EHR MU and PQRS
- High success rate
- Requires EHR certified to the 2014 standards be in place for the full year.
- March 1, 2015 submit signed IRIS Registry agreements to report Stage 2 Meaningful Use Menu Measure 6.
- June 1, 2015 submit signed IRIS Registry agreements for EHR Integration for 2015 PQRS.
- Dec. 1, 2015 submit signed consent allowing data to be sent to CMS.
Option 2: Direct EHR Product
Some EHRs will report directly from EHR to CMS to meet the requirements of PQRS, as well as the CQM requirements for the EHR Meaningful Use Incentive Program. Report nine clinical quality measures across three domains. If your EHR does not contain patient data for nine measures covering three domains, then report all of the measures for which there is Medicare Part B patient data. Physicians are required to report on at least one measure for which there is Medicare Part B data.
Option 3: Cataracts Measures Group
Cataract surgeons can report the Cataracts Measures Group through the IRIS Registry.
New in 2015: This measures group has eight measures.
- Measure 191 Cataracts: 20/40 or better visual acuity within 90-days following cataract surgery, [PDF 282K] and
- Measure 192 Cataracts: Complications within 30 days following cataract surgery requiring additional surgical procedures, [PDF 283K] and
- Measure 303 Improvement in patient’s visual function within 90 days following cataract surgery, [PDF 313K] and
- Measure 304 Patient satisfaction within 90 days following cataract surgery, [PDF 306K] and
- Measure 388 Cataract surgery with intraoperative complications (unplanned rupture of posterior capsule requiring unplanned vitrectomy), [PDF 297K] and
- Measure 389 Cataract surgery: difference between planned and final refraction, [PDF 316K] and two “cross cutting measures”
- Measure 130 Documentation of current medications in the medical record, [PDF 279K] and
- Measure 226 Preventative care and screening: tobacco use: screening and cessation intervention [PDF 277K]
Twenty surgical cases must be reported. Of the twenty, at least eleven patients must have Medicare Part B insurance. The remaining patients may have Medicare Advantage or commercial insurance.
- Low burden option for physicians without EHR.
- High success rate in avoiding PQRS penalty
- Not an option for non-cataract surgeons
- Not an option for attesting for meaningful use
- By Aug. 1, submit signed IRIS Registry agreements.
- By Sept. 30, provide pre-surgical forms and perform at least 20 cataract surgeries
- By Dec. 1, submit signed consent, allowing data to be sent to CMS
- By Jan. 15, 2016 submit all data to IRIS Registry.
Option 4: Individual Measure Reporting via IRIS Registry Web Portal (No EHR)
Physicians without an EHR system can use the IRIS Registry to report individual measures.
Option 4A: Identify nine measures across three quality domains for at least 50 percent of the qualifying Medicare Part B, Medicare as a secondary payer, and Railroad Medicare patients seen between Jan. 1 and Dec. 31, 2015. At least one measure must be a “cross-cutting” measure. When you use the Web portal to select a measure, you will be provided with a measure description that indicates what type of measure it is.
If you report less than nine measures, CMS will use the Measure Application Validity (MAV) process to determine whether you should have reported additional measures.
Option 4B: Identify nine measures across three quality domains for at least 50 percent of total patients seen between Jan. 1 and Dec. 31, 2015. Two measures must be “outcomes” measures, and if two outcomes measures are not available, must report at least one outcomes measure, and one of the following types of measures: resource use, patient experience of care, efficiency / appropriate use, or patient safety. When you use the Web portal to select a measure, you will be provided with a measure description that indicates what type of measure it is.
- Measures do not have to be entered in real time.
- Option B, can report new ophthalmology measures being developed by IRIS Registry not available in PQRS measure set
- More labor intensive than EHR Integration or Cataracts Measures Group.
Option 5: Claims-Based Reporting From Your Office
Physicians who have been successfully reporting PQRS from the office setting may choose to continue to do so. To avoid the penalty, nine clinical quality measures across three domains, including at least one “cross-cutting” measure, should be submitted for at least 50 percent of the Medicare Part B fee-for-service patients seen during the reporting period.
However, in 2015 there are only eight measures that apply to most ophthalmologist that can be reported via claims. This is because the claims-reporting option for Measure 18 Diabetic retinopathy: documentation of presence or absence of macular edema and level of severity of retinopathy was removed. Physicians reporting fewer than nine measures across three domains will be subject to the MAV process.
- There are not nine ophthalmic measures that can be reported via claims.
- All physicians will be subject to the MAV process and may not successfully avoid the penalty.
- This option will likely be eliminated in future PQRS years
Option 6: Group Reporting Option
Ophthalmologists who are part of a large multi-specialty group practice may choose to report every physician in the group reporting option. Details can be found at www.cms.gov.