decisionhealth Newsletters, Answer Books - 2010 Issue 12 (December)
Answer_Book / Quality_Reporting_Initiatives / Group measures reporting
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Article Overview
This article explains how group measures reporting works within a quality reporting program, with emphasis on participation periods, minimum reporting volume, and the difference between claims-based and registry-based submission. It is intended for providers, practices, and coding/billing staff who need to understand the scope of group reporting and the kinds of measure categories involved. The article also discusses startup reporting concepts, measure-group structure, and general reporting considerations for selected clinical groupings.
Why This Topic Matters
Group reporting can affect whether a provider participates successfully in a quality program and qualifies for an incentive. Understanding the reporting framework helps practices choose an appropriate submission approach and align documentation and workflow with the measure-group requirements.
Article Sections
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Group measures reporting
Introduces group-measure reporting as an alternative to individual claims-based reporting and outlines the basic participation timeframe concepts.
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Reporting requirements
Summarizes the general minimum volume expectations for claims-based and registry-based reporting participation.
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Groups of measures
Lists the clinical measure-group categories included in the program year referenced by the article.
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How to report using a measure group on your claims
Describes the high-level structure of claims-based group reporting, including the initial group-level submission concept and ongoing patient-level measure reporting.
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Example
Provides an illustrative scenario showing how one measure group may be reported in practice.
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Note
Offers a general reminder about using outside clinical review information for a measure when applicable.
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Example
Gives an additional example involving a specific measure within a diabetes-related group and a supporting report review scenario.
What You Will Learn
- How group measures reporting differs from individual measure reporting
- What general participation periods are available for group reporting
- What broad reporting thresholds are described for claims and registry submissions
- How measure groups are organized at a high level
- What types of clinical topics are included in the referenced measure groups
- How the article frames startup and ongoing reporting for group measures
Who Should Read This
- Physicians
- Group practices
- Medical coders
- Billing staff
- Quality reporting staff
- Registry users
Codes Discussed
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