What Is PQRS Reporting?


The Physician Quality Reporting System (previously the Physician Quality Reporting Initiative) was introduced by CMS as a way to make sure that physicians could self-report quality of care based on set metrics, to ensure that they are giving the best care to their patients. Because PQRS incentivizes eligible professionals to report on the quality of their patient treatment, the system helps to ensure that there is a quality baseline being reached throughout the Medicare Part B system. PQRS reporting helps providers give better patient care as well as set the metrics most eligible professionals and participating organizations can use to improve their care. Also, it creates a higher standard of performance for patients overall.

Why is PQRS Reporting Useful?

PQRS reporting became a standard for CMS because it helps ensure that there is uniformity in the overall patient care. By using the metrics that PQRS reporting provides, eligible professionals have a more concrete idea of what guidelines Medicare Part B is looking for in their provision of services. This also helps in eliminating costs that are tangential to the patient experience through Medicare Part B.

In short, using PQRS Reporting makes eligible professionals better healthcare providers overall. Patients are often unsure on what constitutes vital care, and it is the task of the medical provider to not only heal but also educate patients towards better health. PQRS reporting through its member registries helps providers focus on the task of providing the best patient care possible.

Who Participates in PQRS Reporting?

PQRS reporting directly affects doctors, healthcare practitioners, and therapists from a wide variety of disciplines, as long as they are part of the Medicare Part B system. This includes medical doctors, optometrists, dentists and oral surgeons, as well as other disciplines such as nurse practitioners and physical therapists. By making sure that the patient experience covers all needed areas regardless of their choice of eligible healthcare professional, PQRS reporting makes it easier for healthcare providers overall to check the areas needed to ensure patient longevity and overall health. PQRS reporting is not done through CMS, however, but through national provider registries who will take the time to submit the data on your behalf.

What Direct Benefits Does PQRS Reporting Have for Patients and Providers?

While there are clearly direct benefits for health professionals who want to make sure that they are adhering to the standards provided by CMS, there are other benefits (as well as negative consequences for non-compliance) to using PQRS reporting. Those not on the PQRS reporting system by 2017– or not compliant by 2017– will receive a negative payment adjustment. Making sure you’re up to the standards now, however, will result in no change to the existing payment structure. CMS is taking the overall quality of patient care by its professional providers seriously, and is committed to making sure that patients get the best care available in the Medicare Part B system.

For patients, this is a huge win– by having consistent standards of treatment, the PQRS system is ensuring that patients are getting the services they need and the knowledge from their providers about making the best choices to stay at their best health.

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