Medical Record Review for PQRS
KDJ Consultants offers medical record review services for Physician Quality Reporting System. PQRS is one of several long-term quality initiatives developed by the Centers for Medicare and Medicaid Services. The Physician Quality Reporting System has been using incentive payments, and began using payment adjustments in 2015, to encourage eligible health care professionals (EPs) to report on specific quality measures.
- PQRS gives participating EPs the opportunity to assess the quality of care they are providing to their patients, helping to ensure that patients get the right care at the right time. By reporting these quality measures, providers also can quantify how often they are meeting a particular quality metric. Using the feedback report provided by CMS, EPs can compare their performance on a given measure with their peers.
- Quality measures are developed by provider associations, quality groups, and CMS and are used to assign a quantity, based on a standard set by the developers, to the quality of care provided by the EP or group practice.
- The types of measures reported under PQRS change from year to year. The measures generally vary by specialty, and focus on areas such as care coordination, patient safety and engagement, clinical process/effectiveness, and population/public health. They can also vary by reporting method.
Why Should You Participate
Participating in the PQRS is voluntary for EPs. The program incentivizes them to participate by using incentive payments and payment adjustments to promote the reporting of quality information. Participants who have successfully met the measure reporting criteria of the program receive a bonus incentive payment. Those EPs however who choose not to report the expected measures, or do not meet the reporting criteria are subject to a payment adjustment penalty.
For complete information see the Centers for Medicare & Medicaid Services (CMS) PQRS website at cms.gov.