decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 9 (September)
Quality reporting: Use your resource reports to prep for PQRS 2016, beat the value-based cut
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Article Overview
This article discusses Medicare quality reporting for physician practices, with emphasis on CMS quality and resource use reports, physician quality reporting system performance, and the value-based modifier payment process. It is aimed at practices trying to understand how report-card style data can help them assess performance, prepare for payment adjustments, and reduce the risk of penalties. The piece also points readers to general report sections and CMS resources used to review quality and cost performance.
Why This Topic Matters
Practices that review these CMS reports can better understand how their quality reporting performance is being measured and where they may be exposed to future Medicare payment adjustments. The article is relevant for organizations preparing for Medicare quality reporting deadlines and payment changes.
Article Sections
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Overview of CMS quality reporting and payment impacts
Introduces the Medicare quality reporting context for physician practices and explains why upcoming reporting performance affects later payment adjustments. It also identifies the provider groups and practice structures referenced in the discussion.
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Download and study your QRUR
Describes the quality and resource use report as a practice-level report card and explains its role in preparing for Medicare quality and payment review. This section focuses on how practices can use the report to understand their current standing.
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Focus on quality if cost-cutting is hard
Discusses the practical challenge of balancing cost awareness with quality reporting efforts. It addresses how practices may approach quality-focused performance improvement when cost reduction is difficult.
What You Will Learn
- What CMS quality reporting materials are used to review practice performance
- How the quality and resource use report helps practices assess their standing
- Why physician quality reporting performance matters for later payment adjustments
- What general report sections practices are encouraged to review
- How quality reporting and cost performance fit into Medicare payment evaluation
Who Should Read This
- Physician practices
- Practice managers
- Coding and billing professionals
- Quality reporting staff
- Medical group administrators
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