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Physician Quality Reporting System
The Tax Relief and Health Care Act of 2006 authorized the creation of the Centers for Medicare & Medicaid Services (CMS) Physician Quality Reporting System (PQRS). This program offers an incentive payment for eligible professionals (EPs) who satisfactorily report data on quality measures. EPs can use participation in the PQRS program to improve the care of patients through evidence-based measures based on clinical guidelines.
In 2012, measures for the PQRS program and Clinical Quality Measures (CQMs) in the CMS EHR (Meaningful Use) Incentive program have been aligned. PQRS affords eligible professionals opportunities for incentives through 2014 based on the EP’s Medicare Physician Fee Schedule (MPFS) allowable charges. Penalties will occur for non-participation starting with the year 2015.
Incentives and adjustments for PQRS are based on MPFS allowable charges for the particular calendar year:
2012 |
2013 |
2014 |
2015 |
2016 and beyond |
+0.5% |
+0.5% |
+0.5% |
-1.5% |
-2.0% |
It is important to note that CY 2013 has been established as the reporting period for the 2015 Physician Quality Reporting system payment adjustment.
Masspro will work with EPs to improve the quality and frequency of preventive health care services to optimize beneficiaries’ quality of life and health care efficiencies. We will work with EPs to begin reporting PQRS data via their EHR. Masspro will provide educational tools and technical assistance to EPs related to clinical quality reporting and improvement.
Focus will be on the following PQRS measures:
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Breast cancer screening
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Colorectal Cancer Screening
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Influenza immunizations of patients ages 50 and older during the influenza season
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Pneumonia immunizations of patients ages 65 and older
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Blood pressure control for patients with hypertension
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Tobacco cessation screening and counseling for smokers
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