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In 2007, CMS launched a pay-for-reporting program. This was known as PQRI—the Physician Quality Reporting Initiative—until the end of 2010, when it was renamed PQRS—the Physician Quality Reporting System. Individual eligible professionals can submit data to the program via: 1) Claims-based reporting, where you include the data on your Medicare Part B claims forms; 2) registry-based reporting, where you submit the data to a qualified registry, which forwards the data to CMS after the end of the calendar year.
From 2007 to 2009, our five-physician practice used claims-based reporting.
We decide to use a registry. After two years without a bonus and 2009’s notification of a bonus still pending, we decided to input our data through Outcome Sciences’ Ophthalmic Patient Outcomes Database (www.outcomes.com/pqri), a web-based registry that listed the Academy among its partners. Our physicians felt strongly that the registry fees and staff time spent on this effort would be worthwhile to ensure that all physicians would qualify for the incentive bonus for 2010.
We decide which measures to report. After the initial training—for which we found the Outcome support team to be very helpful—the next step was to identify the three measures to report for each physician. Within a practice, physicians can select different measures, but all our doctors chose to report the same three measures. Next, we added each doctor’s data.
We start reporting. As we got started, we found the system intuitive to use. The support team would often send e-mail notifications when their system had issues that might hinder the entry process. Unfortunately, we were unable to download through our practice management system by batches. Therefore, in the middle of the year, we began the tedious process of manual entry for all visits from the first of the year (and we reported through the registry in real time from that time forward). To find out what data we needed to enter, we ran reports for the diagnosis codes that corresponded to the chosen measures. These reports showed all of the visits for each patient during that period.
Catching up—we enter data for the first half of the year. It was necessary to enter data for only one of the three chosen measures at a time. To enter data for a patient encounter, we had to go into each of five screens to complete the entry—whereas we would have preferred to have all the information on one screen along with a more natural “flow” of data (e.g., having patient name and demographics together). Furthermore, for each encounter, even for existing patients in the system, we had to enter all of the necessary patient information as if for a new patient. During this catch-up period, our staff estimated that they could spend up to one hour on one patient’s data entry, with an additional five minutes waiting for it to be saved. Because of the massive amount of visits needing to be reported, much of it was done during weekends. We had hoped that the web-based Registry’s usage might be lower at the weekend, but data entry seemed no faster.
Positive results. We were pleased with the ability of obtaining the PQRS provider status report by the click of a button. We also felt that the support team was willing to give helpful tips and worked with our staff to resolve questions. It was beneficial that e-prescribing could be reported for each physician at no additional cost. Overall the physicians were pleased that they seem likely to qualify for the 2010 incentive bonus, and they decided to use the Outcome Registry again in 2011.
For more information on PQRS, visit www.aao.org/pqri.
June 30 Deadline for E-Rx
To avoid the 2012 e-prescribing penalty, you must submit 10 of the required 25 e-prescriptions via claims (not a registry) by June 30, 2011.