Pay for Performance / Several ways to participate in PQRI

Why This Topic Matters

PQRI reporting choices can affect how a practice submits quality data and whether it meets participation requirements for incentive-based reporting. Understanding the available reporting pathways helps staff determine which CMS-supported method is appropriate for their workflow and specialty mix.

Article Sections

1. Overview of PQRI participation options

   Introduces the reporting pathways available through CMS and distinguishes the traditional claims-based approach from newer alternatives. It also places the discussion in the context of CMS quality reporting requirements.

2. Measures groups and registry-based reporting

   Describes the concept of measures groups and the registry option for submitting quality data. The section explains the broad structure of these alternatives and how they relate to CMS reporting criteria.

3. Background and reporting requirements

   Summarizes the legislative background that led to alternate PQRI reporting criteria and periods. It also explains the general purpose of the newer reporting methods.

4. Examples of measures groups

   Provides broad examples of the kinds of clinical areas covered by measures groups and identifies the group-specific identifiers used in the article. The section focuses on how CMS organizes groups of related measures.

5. Claims-based reporting example and related considerations

   Walks through a practical claims-based reporting scenario and notes additional points to keep in mind when using PQRI reporting options. It also discusses how backup participation, registry reporting, and consecutive-patient concepts fit into the overall process.