decisionhealth Newsletters, Coder Pink Sheets - 2014 Issue 12 (December)
PQRS in 2015 will require care in measures selection to avoid 2 pay cuts
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Article Overview
This article explains the 2015 updates to Medicare quality reporting under PQRS and the value modifier. It is aimed at physicians, group practices, registries, and coding/compliance staff who need to understand changing reporting expectations, measure group revisions, and how practice size affects exposure to penalties and incentives. The discussion highlights the kinds of program changes that practices should review when planning their reporting strategy for the coming year.
Why This Topic Matters
Practices that rely on PQRS reporting need to adapt to new measure requirements, revised measure groups, and expanded value modifier applicability. Understanding these changes helps organizations prepare for compliance and avoid payment adjustments.
Article Sections
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5 key changes to note for 2015
Introduces the major 2015 program changes that practices should review when planning reporting and compliance activities.
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Report nine measures to avoid penalties
Discusses the updated reporting expectations for avoiding quality reporting penalties and the role of applicability validation review.
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Include at least one cross-cutting measure
Covers the addition of cross-cutting measures and how they relate to face-to-face visits and registry support considerations.
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Measures groups were redefined and four were deleted
Summarizes changes to measures groups, including redefinition, deletions, and newly added groups.
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Watch out for the value-modifier adjustment
Explains how the value modifier changes for 2015 and how practice size affects potential payment adjustments.
What You Will Learn
- How the 2015 PQRS reporting environment changed
- Which broad categories of measures and measure groups were revised
- How registry support factors into measure selection
- How the value modifier expanded to additional practice sizes
- Which Medicare program areas practices should review before reporting
Who Should Read This
- Physicians
- Eligible professionals
- Group practices
- Solo practitioners
- Non-physician practitioners
- Medical coders
- Quality reporting staff
- Compliance staff
- Registry vendors
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