Health IT Newsletter – January 2014

Good morning all,

I personally wanted to thank everyone for all the help and feedback provided as we collect physician signatures for the Meaningful Use (MU) Reports distributed to all clinical administrators. In 2014, as an institution we shall continue to collect and report MU Stage 2 data to CMS.

As a part of a promised update regarding some 2014 initiatives I would like to give some basic information on Physician Quality Reporting System (PQRS) and Clinical Quality Measures (CQMs).

PQRS

What is it?  The Physician Quality Reporting System (PQRS) formerly known as the Physician Quality Reporting Initiative (PQRI) is a reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs).  This applies specifically to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer).

How does it affect us?  As an institution, we have decided not to attempt to garner incentive payments, but rather avoid penalties.  Starting in 2015, PQRS applies a penalty to EPs who do not satisfactorily report data on quality measures for covered professional services.  This penalty will start at 0.5% and increase to 3%.  For 2014, we are required to report 9 or more individual PQRS measures on at least 50% of Medicare Part B FFS patients.

CQMs (Clinical Quality Measures)

What are they?  Clinical quality measures, or CQMs, are tools allowing CMS to measure and track the quality of healthcare services provided by eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs).  These CQMs are divided into healthcare domains:

  • Patient and Family Engagement
  • Patient Safety
  • Care Coordination
  • Population/Public Health
  • Efficient Use of Healthcare Resources
  • Clinical Process/Effectiveness

How does it affect us?  In our recently concluded Stage 1 of MU, each provider had six total CQMs measured and reported to CMS.  For 2014, all providers will be required to report 9 CQMs from 3 of the above listed domains.

Bottom Line:  Over the next month, I will visit with each department chair, administrator, and selected clinical faculty to identify measures that will allow us to fulfill BOTH PQRS and CQMs simultaneously.  To prepare for this I attached:

  1. 2014 PQRS measures list
  2. 2014 CQM list
  3. 2014 Recommended Adult CQMs
  4. 2014 Recommended Pediatric CQMs

I will work with your department to choose measures to meet these clinical metrics. These measures will be within your current clinical workflow and take into account departmental priorities (i.e. PCMH, Patient Portal) you may have for 2014.

Rationale:  Many persons have asked “Why all the change?”  Put simply, change is constant and we are in a period of multi-faceted change in our healthcare environment.  Both CMS and the Institute of Healthcare Improvement (IHI) strongly believe that to optimize our healthcare system, the “Triple Aim” must be pursued. These are:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

Going Forward:  In the next few weeks I shall send a campus-wide email outlining changes that affect us clinically within MU Stage 2 for 2014.

Thank you and feel free to contact me with any questions that may arise.