5 Ways Medicare Encourages Electronic PQRS Reporting > Michigan State Medical Society


5 Ways Medicare Encourages Electronic PQRS Reporting

It's generally understood that all Eligible Providers must file PQRS in 2015 to avoid 4% to 6% penalties from being withheld from their Medicare payments in 2017. What isn't widely known is how easy compliance can be when using the services of a data submission vendor (DSV).

Working with a DSV is an option available to any practice using a Meaningful Use phase 2 compliant EHR. The Lake Superior Quality Improvement Network (LSQIN) reports that Medicare wants providers to file electronically because doing so is more efficient, cost-effective, and eliminates the risk of errors incurred during the filing process.

To encourage more providers to file PQRS data using a DSV (rather than a Registry), Medicare created several regulatory advantages for doing so:

  1. When filing through a DSV, providers who do not have 9 measures across 3 quality domains are not subject to the MAV (Measure Applicability Validation), process. MAV is an intense process that ensures a provider didn't fail to report additional measures that they should have. Because a DSV extracts, aggregates, and files all of a provider's quality data, Medicare knows that no measures were missed, and therefore MAV is unnecessary.
  2. A Provider with fewer than 9 measures across 3 quality domains is not penalized via lower Value Based Payment Modifier payments. Medicare ignores all measures with a 0 score and calculates 100% of a provider's VBM quality score on the measures that do have a score. This is a huge coup for specialists who often have difficulty identifying 9 measures to report; now they are only graded on the measures for which they do have a score.
  3. Filing through a DSV means there are no measures groups. Electronic filing has a pool of 64 measures available, and none are organized in groups; rather they are all equal and function independently. Any provider can report any of the 64 measures, and it is very rare that a provider doesn't satisfy at least several. This means a provider can focus on what's most important during an exam without spending time asking many potentially unnecessary for the sake of satisfying measures groups.
  4. There are no cross-cutting measures. Cross-cutting measures are special measures which also must be reported when using Registry- or Claims-based reporting. Cross-cutting measures are another way that Medicare ensures a provider is reporting all appropriate quality data. When filing electronically, all of a provider's quality data is automatically reported, making cross-cutting measures unnecessary.
  5. Your DSV submission automatically satisfies three requirements. Medicare has aligned multiple programs to use the same 64 quality measures. When a provider electronically files eCQMs, that filing now satisfies three regulatory requirements: PQRS, Value Based Modifier, and Meaningful Use eCQMs. The MU eCQMs are a key component of the Meaningful Use program, which puts an additional 3% of reimbursements at risk in 2017.

Working with a data submission vendor such as Health eFilings that offers a proprietary software solution to fully automate the entire submission process eliminates complex and costly clinic workflows while ensuring providers will not be penalized for accidental omissions or data entry errors. Health eFilings' PQRS Accelerator can extract data from any MU2-compliant EHR to satisfy multiple program requirements. Additionally, Health eFilings' software will ensure the best scoring measures are reported, thereby putting a provider's best foot forward when positioning for maximum available incentives.

Explore how PQRS Accelerator would benefit your organization by visiting Health eFilings online, and call James Reuter, MBA at (608) 416-9529.

Posted in: Federal Government News, Medicare, Hot Topics, News for Practices