Double down on EHR and PQRS incentives

Double down on EHR and PQRS incentives

If you treat Medicare patients and bill for Part B services on the Physician Fee Schedule, you may be eligible for two incentive programs offered by the Centers for Medicare & Medicaid Services (CMS).

The Medicare EHR Incentive Program offers payments to eligible professionals (EPs) who successfully demonstrate meaningful use of certified EHR technology. Additionally, the Physician Quality Reporting System (PQRS) provides payments to promote EPs' reporting of quality information.

According to CMS, EPs who successfully participate in the EHR and PQRS programs can receive incentives in 2013 -- and can avoid the scheduled 2015 payment adjustment for both programs.

"To successfully demonstrate meaningful use for the Medicare EHR Incentive Program, EPs are required to report clinical quality measures [CQMs] as well as meaningful use measures," CMS said in guidance to EPs issued May 10.

The agency explained that in 2013, EPs may satisfy the meaningful use objective to report CQMs by submitting them through the Registration and Attestation System. However, EPs who choose to report CQMs through that system must still report information on individual quality measures or measure groups using one of four reporting options in order to also participate in PQRS.

CMS said EPs may also participate in the PQRS-Medicare EHR Incentive Pilot, which utilizes the 2013 PQRS EHR Measure Specifications. The agency noted that EPs who participate in the pilot may submit their meaningful use objectives through the CMS Attestation system, and then complete a single submission of CQMs to receive credit for both programs.

2014 and beyond
CMS pointed out that in 2014, the EHR and PQRS programs "have overlapping participation guidelines, including the same quality measures, the same reporting criteria and the option to use the same reporting mechanism." The agency said its goal is to simplify participation in both programs.

CMS offered the following key points to keep in mind for EHR and PQRS alignment in 2014:

  • EHR and PQRS programs will align on the same set of CQMs (64 total) and the same electronic specifications.
  • All Medicare EPs beyond their first year of demonstrating meaningful use will be required to electronically report their CQM data to CMS for the EHR program.
  • Submitting data electronically using 2014 certified EHR technology will meet the standards for both the EHR and PQRS programs.
  • Participating EPs will have the option to submit patient-level data or aggregate data using the same reporting mechanism for electronic reporting for both programs.

Further information on the EHR and PQRS programs can be found on CMS' eHealth website.