Have You Reviewed Your PQRS Report Yet? (you should have received it by now)

PQRS ReportingPQRS is important.  Physicians who did not successfully participate in PQRS in 2013 will receive a negative 1.5 percent payment adjustment on their Medicare Part B fee-for-service claims next year.  The Centers for Medicare & Medicaid Services (CMS) released the Physician Quality Reporting System (PQRS) feedback reports for 2013 last month.  The also released separate 2015 PQRS payment adjustment feedback reports.  Incentive payments will be disbursed next month.

You can download the reports if you have an up-to-date “Individuals Authorized Access to the CMS Computer Services” (IACS) account.  If you don’t have an account or your account is outdated you can register online HERE.  The user guide for the feedback reports can be downloaded HERE.

If you are affected by the 2015 PQRS payment adjustment you should receive a notification letter from CMS later this year.

PQRS is the foundation for Value-based Payment Modifier (VBPM) system that greatly affect CMS reimbursements going forward.  If you participate in any CMS programs it is important that you are aware of these two programs and are participating in them.

A lot of groups have let VBPM slip under their radar because practices face what the AAFP called “the perfect storm” of regulatory compliance this year with the Affordable Care Act, Meaningful Use Stage 2, PQRS, Value-based payment modifiers and of course – ICD10.  It’s just too much.   In Chicago I recently addressed an audience of over 100 of the largest ambulatory organizations in the country and asked how many had heard of VBPM or value-based payment modifiers.  Out of over 250 attendees only two raised their hands.

This is the state of things.  Many of these groups should have been participating in VBPM in 2013.  Groups of 10 providers or more need to participate this year or face penalties.  With all that is going on VBPM has simply slipped under the radar.  If these more sophisticated groups are finding it hard to keep track of all that is required, what are the chances that the smaller groups that are far more resource-constrained are going be able to?

Be sure you are keeping up with PQRS and VBPM.  I want to make sure you are collecting every last dollar you deserve.