decisionhealth Newsletters, Part B News - 2009 Issue 7 (July)
CMS wants minimum patient requirements to earn PQRI bonus
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Article Overview
This article covers proposed changes in the 2010 Medicare Physician Fee Schedule affecting the Physician Quality Reporting Initiative (PQRI). It focuses on minimum patient reporting requirements, claims-based versus registry-based reporting, a new electronic health record reporting option, and a proposed group practice reporting pathway. The piece is aimed at physicians, practice managers, and coding/compliance staff tracking Medicare quality-reporting policy.
Why This Topic Matters
The proposed changes could affect whether providers qualify for a PQRI bonus and how they report quality measures under Medicare. It is relevant for practices evaluating reporting workflows, eligibility thresholds, and future participation strategies.
Article Sections
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Overview of proposed PQRI changes
Introduces the CMS proposal for 2010 and summarizes the major reporting-policy changes under consideration.
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Minimum patient requirements for bonus eligibility
Describes the proposed patient-volume thresholds tied to bonus qualification for different reporting approaches and reporting periods.
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Claims-based reporting changes
Addresses the proposed direction for claims-based reporting and the agency’s longer-term intent regarding that option.
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New EHR reporting method
Explains the addition of an electronic health record reporting pathway and the broad structure of that option.
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Group practice reporting option
Summarizes the proposed reporting pathway for larger group practices and the process CMS says would be required to use it.
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Comment period and reporting comparison
Notes the public-comment deadline and presents a comparison of PQRI reporting options for 2009 and proposed 2010.
What You Will Learn
- How CMS proposed to change PQRI participation requirements for 2010
- What broad patient-volume thresholds were tied to bonus eligibility
- How reporting options differed across claims-based, registry-based, and EHR-based methods
- What the proposed group practice reporting pathway involved
- When CMS was accepting comments on the proposed rule
Who Should Read This
- Physicians
- Group practices
- Practice managers
- Medical coders
- Compliance staff
- Quality reporting staff
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