PQRS 2015 Medicare Final Rule: Quality Provisions Highlights: Say Goodbye To PQRS Incentives

Why This Topic Matters

Quality-reporting participation and performance can affect Medicare payment adjustments, so changes to incentives, penalties, and eligible measures directly influence compliance planning and reimbursement strategy for physician groups and individual practitioners.

Article Sections

1. Overview of PQRS and payment changes

   Introduces the 2015 final rule and the shift in Medicare quality reporting from incentives toward penalties. It frames the broader reporting and payment timeline discussed in the article.

2. No Carrot, Just An Increasingly Larger Stick

   Summarizes the article’s discussion of the changing PQRS incentive structure and related payment adjustment concepts. It also places the 2015 reporting year in the context of later Medicare adjustments.

3. Be Aware of These Three National Quality Strategy Domains

   Describes the reporting framework tied to National Quality Strategy domains and cross-cutting measure expectations. The section focuses on the categories of quality measures referenced in the final rule.

4. You Can Forget These Key Emergency Care Measures

   Covers emergency medicine measures discussed in relation to PQRS reporting and identifies that some commonly used measures were removed. It also notes the article’s mention of other potentially available measures for emergency physicians.

5. Don’t Overlook Value-Based Modifier (VBM)

   Explains the article’s overview of the Value-Based Modifier and how group performance is addressed in the 2015 final rule. The section discusses the relationship between PQRS reporting and later payment-tiering concepts.