At the end of November, Medicare released its Final Rule, which, among other things, included all the nitty gritty details of next year’s physician quality reporting system (PQRS). And if there was any doubt that registry-based reporting with an EMR was the way to go in 2013, there isn’t any in 2014. Here’s why:
1. Registry-based reporting is much easier.
Your first decision when it comes to PQRS—assuming that you’ve already acknowledged that it’s in your very best interest to comply—is which reporting method to use: claims-based (lots of work) or registry-based (easy as pie). You see, with claims-based reporting, it’s all on you. You’re responsible for remembering what to report, for whom, and how frequently as well as for correctly documenting and submitting the data to Medicare. With registry-based reporting, on the other hand, your EMR will take care of the heavy lifting for you. It’ll prompt you to answer the necessary PQRS questions at the required times during normal documentation, compile the data for you, and electronically submit it to CMS on your behalf. With registry-based reporting, you may even have enough time left over to actually bake that pie.
2. There’s a hefty penalty for noncompliance.
If you’re not PQRS compliant in 2014, Medicare will assess a 2% payment adjustment in 2016 (up from 1.5% in 2013). Also, next year may be the last year that you can earn an incentive—0.5%—for compliance. So now is definitely not the time to take on all the intricacies and complexities of PQRS on your own—especially considering that the requirements for compliance just got a whole lot tougher.
3. With registry-based reporting, you’ve got way more options.
In 2014, the easiest way for physical therapists with a large number of Medicare patients to avoid the penalty and earn the incentive is to report the Back Pain Measures Group for at least 20 patients, most of whom must be Medicare Part B fee-for-service (FFS) patients. Sounds great, right? Well, the only way to use the measures group reporting option is to do so through a registry.
If you’d rather not use the measures group option because maybe you don’t treat many Medicare patients, you can still use a registry to avoid the penalty and earn the incentive by reporting nine measures, covering three national quality standard (NQS) domains, on at least 50% of your Medicare Part B FFS patients. You can do so as a group (GPRO) or as an individual.
Through claims, you can only report as an individual, and the reporting requirements (nine measures, covering three NQS domains, on at least 50% of Medicare Part B FFS patients) remain the same. However, there are only eight claims measures that apply to physical therapists, which means that all PTs who opt to use claims-based reporting are subject to the Measures Applicability Validation (MAV) process. This is how Medicare will determine if an eligible professional should have reported additional measures and/or covered additional NQS domains. In other words, it’s just another potential PQRS complication.
You already have enough on your plate—like running your business, treating your patients, and preparing for the ICD-10 transition. Don’t take on PQRS all by yourself. Instead, choose registry, and you’ll have a partner in compliance and a significantly better and less stressful 2014.