Have you checked your QRUR to find out if you qualify for a CMS bonus (or penalty)?

November 25th, 2014

What? You've never heard of a QRUR?  

You have probably heard about Meaningful Use (MU) and penalties that kick in for those who did not attest. And the Physician Quality Reporting System (PQRS) with penalties for those who did not successfully report on at least one patient. The new one is the Value-Based Modifier (VBM or VM) which is another program the government is using to try to reduce costs while improving care. Note that all of these programs combined could result in as much as a 4% bonus all the way down to a 12% penalty.

On September 30, CMS made 2013 Quality and Resource Use Reports (QRURs) available to physician solo practitioners nationwide. The QRURs contain quality and cost performance data for 2013. They tell you how you would be penalized or rewarded if your 2013 numbers were used to select your Value-Based Modifier in 2015. Fortunately this report is just an FYI. The modifier won't be applied to physician payments for items and services furnished under the Medicare Physician Fee Schedule for individual eligible professionals (EPs) until 2017, based on PQRS data and cost performance data gleaned from your claims submitted in 2015. 

The take home message, then, is to access your QRUR to see how you would do if the VBM were applied in 2015. Then make sure you report PQRS in 2015 and provide high quality, low cost care. Authorized representatives access the QRURs at https://portal.cms.gov, using a valid Individuals Authorized Access to the CMS Computer Services (IACS) User ID and password. A solo practitioner or an authorized representative of a solo practitioner must obtain an IACS account with one of the following individual-specific PV-PQRS System roles:

Quick reference guides that provide step-by-step instructions for requesting each Physician Value-Physician Quality Reporting System (PV-PQRS) system role for a new or existing IACS account are available in the "Downloads" section on the Self Nomination/Registration web page. Visit the 2013 QRUR and the How to Obtain the 2013 QRUR web pages for more information on the 2013 QRURs. 

This program will impact your practice in other ways, such as the Physician Compare website, which will allow consumers to see how you measure up.  It may also pave the way for private payers who want to move to a pay-for-quality instead of a pay-for-quantity approach to health care. Watch for webinars from ChiroCode about the Value-Based Payment Modifier in 2015 as more information becomes available.

Have you checked your QRUR to find out if you qualify for a CMS bonus (or penalty)?. (2014, November 25). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/have-you-checked-your-qrur-to-find-out-if-you-qualify-for-a-cms-bonus-or-penalty-25617.html

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