decisionhealth Newsletters, Coder Pink Sheets - 2014 Issue 9 (September)
PQRS: Prepare for more requirements, cuts to claims-based measures
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Article Overview
This article explains proposed changes in the 2015 Medicare physician fee schedule that would affect PQRS participation, quality reporting methods, cross-cutting measures, measures groups, and the public reporting environment tied to Physician Compare. It is aimed at physicians, non-physician practitioners, practice managers, and coding or quality reporting staff who need to understand how the proposed changes could affect reporting workflows and future payment adjustments. The discussion focuses on broad categories of guidance, reporting trends, and program refinements rather than on detailed code-level instructions.
Why This Topic Matters
The proposed changes could affect how practices report quality data, which measures they can use, and whether they face payment adjustments. Early awareness helps practices evaluate reporting options, align internal workflows, and prepare for a more demanding Medicare quality reporting landscape.
Article Sections
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Quality reporting changes in the proposed 2015 physician fee schedule
Introduces the scope of the proposed Medicare changes and why practices are being advised to prepare early. Covers the general direction of PQRS requirements and the impact on reporting strategy.
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PQRS requirements and cross-cutting measures
Describes the broader PQRS participation expectations and the addition of cross-cutting measure concepts. Explains who may be affected and the types of reporting categories involved.
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Changes to measures groups
Summarizes proposed revisions to measures groups, including the removal and addition of groups and a higher minimum reporting count. Focuses on planning implications for practices that rely on group reporting.
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Expect the number of claims-based measures to drop
Covers the continuing shift away from claims-based quality reporting and the alternative reporting pathways being emphasized. Discusses the general effect on individual measure reporting approaches.
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2 shortcuts to PQRS success
Presents high-level strategies for managing the reporting workload across a practice. Highlights broader workflow planning and the use of reporting systems to support compliance efforts.
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More refinements ahead for quality programs
Reviews additional proposed updates affecting the value modifier and Physician Compare. Also notes public reporting considerations and opportunities for feedback on future display options.
What You Will Learn
- How proposed Medicare quality reporting changes may affect PQRS participation
- Why practices are being encouraged to prepare for a more demanding reporting environment
- What broad changes are being discussed for measures groups and claims-based reporting
- How quality reporting programs connect to payment adjustments and public reporting tools
- Which reporting workflows may become more important for future compliance
Who Should Read This
- Physicians
- Non-physician practitioners
- Practice managers
- Medical billing and coding staff
- Quality reporting staff
- Healthcare consultants
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