PQRS: What to Know for 2014 and What’s in Store For 2015

Wednesday, December 17, 2014
WEST LAFAYETTE,  – 

As the year is coming to an end, so is the reporting period for the Physician Quality Reporting System (PQRS) for 2014. Purdue Healthcare Advisors' Managing Advisor for EHR/Meaningful Use Tara Hatfield has been helping clients understand the updated rules associated with PQRS and the Physician Value-Based Payment Modifier (VBPM).

Although the reporting period ends on December 31, 2014, providers have until March 31, 2015, to submit their PQRS data to CMS. In 2014, providers have five methods by which they can report nine measures that cover three National Quality Strategy (NQS) domains. The methods are 1) claims-based, 2) a Qualified PQRS Registry, 3) a Qualified Clinical Data Registry, 4) a direct EHR, and 5) EHR Submission Vendor.

When reporting PQRS measures, there are a few special considerations. If you are using a Qualified PQRS Registry or Qualified Clinical Data Registry, be aware that some registries have internal deadlines that differ from the CMS deadline. Because the registry will need time to submit the data to CMS on the provider's behalf, they likely will have an earlier deadline for the data to be submitted to them. You may want to consider participating in data submission testing with your EHR vendor to ensure your PQRS data will be successfully received by CMS.

On October 31, 2014, CMS finalized the 2015 PQRS and VBPM polices for 2015. In the final rule were a few key changes that providers will need to be aware of in the coming year, including the addition of “Cross Cutting Measures” as well as a revised list of individual measures and measures groups; a new reporting sample size for GPRO Web Interface reporting; and new guidelines for reporting the CG-CAHPS Survey. The final rule finalized the phase in which all providers are subject to the VBPM in 2017, and also increased the maximum downward payment adjustment to -4% and maximum upward adjustment under the quality tiering methodology to 4x% (where x equals the upward payment adjustment factor).

Tip Sheet outlining the PQRS and VBPM changes for 2015 (pdf)

CMS 2015 Medicare Physician Fee Schedule (MPFS) Final Rule (pdf)


Tara Hatfield

Tara Hatfield, RN, BSN, Purdue Healthcare Advisors' Managing Advisor for EHR/Meaningful Use, has been helping clients understand the updated rules associated with PQRS and the Physician Value-Based Payment Modifier (VBPM).


Tags: Quality Services

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