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What is the Best PQRS Reporting Method?

  Sep 19th, 2015   -     News   -  

Over half of eligible providers didn’t file PQRS data in 2013, most saying it was too difficult to do and not worth their time. However, Medicare has significantly increased penalties in 2015, meaning that most eligible providers will lose an estimated $18,000 in reimbursements on average in 2017. Few practices can afford not to file this year.

Electronic filing of PQRS data is a game changer for any practice using an EHR. Here’s how this new filing technology helps practices save time and avoid steep penalties.

  • No need to select measures
  • No claims-level work or chart abstraction
  • No IT resources needed
  • No forms to fill out
  • Works across multiple EHRs

No need to select measures

If you attempt to manually file PQRS, the first critical step is to select the measures on which you will report for each provider. Each provider must report on 9 measures across 3 domains. If providers are in different specialties, some providers will score better in some measures while other providers score poorly; therefore it’s necessary to choose the 9 measures that best represent each provider. Extensive time is required to evaluate all available measures and predict which will best represent each individual physician – time that is better spent on activities like patient care.

A full-service data submission vendor (DSV) automatically extracts all quality data for all patients seen by every eligible provider in 2015, and selects the best 9 quality measures for each provider. Clinic administrators do not need to review and select measures, and are also assured of the highest scoring report being generated since the best measures are automatically selected for each provider.

No Claims-level Work or Chart Abstraction

Filing PQRS using Claims or Registry filing methods both require extensive staff time to collect and aggregate patient-level data. When filing via Claims, a practice needs to manually record and then calculate quality data for every Medicare patient. A practice using a Registry needs to manually select 20 patients from each provider, at least 11 of which must be Medicare patients, and extract the appropriate quality data from each. Because Registry reporting uses a subset of patients, there’s a risk that those patients will not accurately represent the provider’s best practices, causing them to score poorly when they did in fact perform well throughout the year.

By contrast, a full service DSV like Health eFilings extracts all patient data from the EHR, so PQRS data accurately reflects the EP’s clinical work as a whole. Because the DSV does all of the work directly with the EHR, there is nothing for the practice’s administrative staff to do.

No IT Resources Needed

The next essential step is extracting quality data from the EHR. Few EHRs have this built into pre-configured reports; most practices outsource this aspect to expensive consultants, make time-consuming requests of their IT staff to manually extract this data, or maintain an extensive (and expensive!) infrastructure of IT personnel, custom-architected scripts and hardware to achieve the needed functionality. It’s often necessary to engage with the EHR developer to acquire this data, which is yet another hurdle that precludes practices from participating.

Health eFilings’ proprietary software, by contrast, uses government-mandated functionality built in to every MU2-compliant EHR to extract quality data. There is no need for IT to write scripts or pull reports; once they have a login, Health eFilings does all the work of extracting the data.

No Forms to Fill Out

The next step is getting the practice’s quality data to Medicare. If using a Registry, this means manually entering each provider’s quality data on a series of online forms – up to 20 pages per physician. Not only is this labor-intensive, but there is significant opportunity for data entry errors, which will cause a practice’s submission to be rejected by Medicare. (When a practice’s PQRS data is rejected, the practice is subjected to the full penalty even though they went through the work of filing.) Some Registries will allow a practice to upload their provider data into their system, however practices often struggle with formatting data properly, causing costly time delays and requiring more staff resources to resolve.

The process is completely different when filing electronically. A DSV like Health eFilings does all of the work so there is nothing for the practice to do. The DSV’s software extracts, calculates, formats, and submits the practice’s data with no clinic staff intervention.

Additionally, PQRS data submitted through Health eFilings also satisfies Medicare’s Value Based Modifier (VBM) requirement, and Meaningful Use eCQMs. By contrast, practices that use Claims or Registry reporting will also need to aggregate and file these measures separately.

An added bonus to using a DSV like Health eFilings is that it is easy to extract and combine patient quality data from multiple EHRs. The data is then de-duplicated, aggregated, and reported to Medicare in a single, accurate master file.

Most practices with an EHR benefit from using electronic filing to submit PQRS data. From saving up to 40 hours of staff time per provider to not needing to maintain costly IT infrastructure or expensive consulting contracts, practices eliminate the risk of submitting inaccurate data or accidentally omitting eligible providers, which can result in steep reimbursement penalties. A full-service DSV eliminates what is otherwise an arduous task.

Next week we will discuss when is the best time to sign up with a DSV.

 

To learn more about PQRS click here.