AQuIRE - Physician Quality Reporting Initiative

Physician Quality Reporting Initiative

What is PQRI?
Pay-for-performance initiatives are developed in nearly all sites of service to focus on the performance of quality medicine. In December 2009, the Centers for Medicare and Medicaid Services (CMS) Physician Quality Reporting Initiative (PQRI) finalized its list of performance measures specific for the 2010 initiative, which began January 1, 2010, or, if physicians are reporting for 6 months, beginning July 1, 2010.

Measures and Measure Groups for Chest Medicine
For 2010, there are three reporting options: claims-based, registry, and measures groups. In regard to chest medicine, the eight specific measures (two for COPD, four for Pneumonia, and two for Asthma) are the same as in previous years, with the addition of a Community-Acquired Pneumonia (CAP) measure group for the year 2010.

What Is the Financial Incentive for PQRI?
If you participate in PQRI 2010, you can receive an incentive payment of 2% of all of your total allowed charges for physician fee schedule (PFS)-covered services.*

For example, you have $1 million in claims, and 58% of the claims are collected. Assuming 42% was Medicare, your 2% PQRI incentive payment would be $4,872.

How To Report
Specifications of these measures are detailed on the CMS Web site under “measures codes.” We have also provided additional information, along with a sample of quality reporting specific to chest physicians.
Download the Practice Management PDF.

In addition to the traditional reporting methods, chest physicians can use the PQRIwizard to report on the CAP measure group.  Data will be collected on the following measures:

• Vital Signs
• Assessment of Oxygen Saturation
• Assessment of Mental Status
• Empiric Antibiotic

Download the CAP PQRIwizard Data Collection Instrument

What Is PQRIwizard?
The PQRIi is a fast, convenient, and cost-effective online tool to help collect and report quality measure data for the CMS PQRI incentive payment program. Similar to online tax preparation software, the PQRIwizard helps guide you through a few easy steps to help rapidly collect, validate, report, and submit the results to CMS for payment. The PQRIwizard is powered by the CECity Registry™, a CMS-qualified registry for PQRI reporting.

Why use PQRIwizard?

• Maximize your PQRI incentive
• Automatic data validation
• Minimize data entry time (Requires as few as 30 patient records)
• Eliminate claims and coding

Many PQRI registries require that you collect data from 80% of all of your eligible Medicare patients. The PQRIwizard simplifies the entire process by using the measure group approach. Using the PQRIwizard, you only have to collect 30^† patient visits from the entire year to complete your report!

Plus, PQRIwizard has a built-in Progress Monitor that checks for missing data to validate your report. The Progress Monitor tracks your data to provide you with continuous feedback regarding valid patients, and provides an alert when you have met all submission criteria and your data is ready to be reviewed and submitted. The system even calculates your measures and provides a printable report of your measure results in real time.

How do I participate?
Use the PQRIwizard to submit your PQRI data. All you need to do is register, select the CAP measure group, and then answer a few questions per patient. PQRIwizard takes the guessing out of PQRI participation–just follow the simple steps and let the wizard do the rest!

How much does it cost to participate?
The cost is $249 per physician.

Where do I register?
Register here

The ACCP encourages all practices to participate in PQRI. If you have any PQRI-related questions, please contact the ACCP Coding and Reimbursement Consultant, Diane Krier-Morrow, at dkriermorr@aol.com or (847) 677-9464.  For questions regarding the PQRIwizard, please send an e-mail to aquire@chestnet.org.

* Submission of data to CMS is not a guarantee of payment by CMS.
† You will need to collect 30 consecutive patient visits with a minimum of two Medicare Fee for Service patients.