Policy Update

PQRS Update

Update on PQRS Program – April 2014

The CMS website is a great source of information – but it can be almost too much information. We have pulled forward here some important highlights and tidbits along with highlighting some of the ways the REVEALware™ tool can help.

  • Group Reporting (GPRO) via web interface is now an option for practices with as few as 25 Eligible Providers (EPs).
  • Requires nearly no staff time to pull the data together and report. Data is extracted from your EHR(s), aggregated and measures analyzed against standards and uploaded directly to CMS.
  • Group Reporting aggregates the performance of all your EPs thereby smoothing out the potential impact of underperforming practitioners.
  • REVEALware™ is vendor neutral and can extract across multiple data sources.
  • REVEALware™ offers concurrent quality measures reporting that supports clinical and operational improvements during the year being measured thereby greatly improving your ability to meet all measures (avoid penalties) AND increasing your ability to qualify for incentive payments.
  • Concurrent reporting = monthly, or near real time data extracts of defined data to REVEALware™
  • Concurrent reporting functionality helps make Tiered Value Based Modifier (VBM) incentives an option because you will know how your entire practice is performing against quality standards.
  • In 2015 (for reporting year 2013) only practices with more than 100 EPs can self-nominate, in reporting year 2014 practices with as few as 10 EPs can self-nominate. By 2017 ALL practices, including fee for service providers will be effected by the VBM program.
  • SaaS keeps your records either in house or in a private cloud which means your records and information are secure not handed off to an outside vendor to parse and create reports. Anytime information is handed off there exists an opportunity for handling errors.
  • Group Analysis and Reporting of your practice supports and helps facilitate the transition to total quality based performance and compensation by allowing you to monitor the entire practice and move beyond simply compliance base reporting of quality performance. The concurrent reporting option of REVEALware™ allows monthly reporting on all measures for all EPs reports down to the patient level to support clinical outreach activity.
  • Allows you to track, measure and integrate patient care across multiple facilities.
  • A common measurement platform organized around medical conditions, or a set of closely related conditions supports integrated, accountablecare delivery and reporting.
  • Tracking outcomes by medical condition supports decision making about right sizing service line offerings and service alliances. Allows networks to identify and focus on high-value providers for each condition.
  • Tracking and accountability at facility, practice, department, doctor, patient and disease state.