Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Quality Measurement and Improvement
Lecture:Current quality measures in use
Slide content:Reporting for Outpatient Setting In United States, major efforts led by Centers for Medicare and Medicaid Services (CMS: http://www.cms.hhs.gov ) in Medicare program Physician Quality Reporting System (PQRS, formerly PQRI: http://www.cms.hhs.gov/pqri ) Initially reimbursed extra 1% for reporting on large number of measures Also offered 0.5% for maintaining certification Penalties for failing to meet objectives began in 2015 Electronic Prescribing (eRx) Incentive Program ( http://www.cms.gov/ERxIncentive ) Reimbursed extra 1% for using eRx (through 2013) Began penalizing in 2012 for non-use of eRx 7
Slide notes:What about quality reporting in the outpatient setting? In the United States, efforts in this setting are led by the Centers for Medicare and Medicaid Services (CMS, [C-M-S]) , mostly in the Medicare program. The major CMS program is the Physician Quality Reporting System (PQRS, [P-Q-R-S]), which was formerly called Physician Quality Reporting Initiative. The program initially provided physicians participating in Medicare an extra one percent reimbursement for reporting on a large number of measures (a total of one hundred ninety-four in 2011). They also received zero-point-five percent for maintenance of certification in their medical specialty. Starting in 2015, the bonus changed to reduced payments for participants who did not meet specified objectives. Another CMS program was the Electronic Prescribing (eRx, [E-R-X]) Incentive Program. This program initially provided an additional extra one percent reimbursement for use of e-prescribing. In 2012, the bonus incentive period expired, and payment reductions began for participants who did not meet specified objectives. 7