2016 PQRS Performance Rates and Measures

Tuesday, June 7, 2016

What are the performance rates and measures for PQRS? There are 2 reporting rates that are taken into consideration under PQRS: Reporting Rate and Performance Rate. The reporting rate refers to how many Medicare Part B beneficiaries were reported for in each measure reported. The requirement for successful PQRS reporting is that at least 50% of all Medicare beneficiaries eligible for measure must be reported on.

The Performance Rate is the number of the Medicare beneficiaries reported for a measure that counted positively in the numerator of the measure. Unless the measure is an inverse measure (where a zero in the numerator is indicates better quality), each measure must score greater than 0% to be considered successfully reported. There is no additional threshold. Most PQRS reporting methods require 9 PQRS measures that cover 3 National Quality Strategy (NQS) domains to be reported. Other methods have additional measure reporting options such as Measures Group reporting available for individual reporters using a PQRS registry or the GPRO Web Interface that has a set of 17 predetermined measures for group reporters.

Additionally, a Cross-Cutting measure must be included in the set of measures each provider or GPRO selects to report. A Cross-Cutting measure is a measure that is broadly applicable to most practices and specialties.


CMS Resources

About PQRS - https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html?redirect=/pqrs

How to get started - https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/How_To_Get_Started.html

Measure Selection - https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html

Writer: Tara Hatfield, 812-525-0023, thatfie@purdue.edu

Tags: Quality Services

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