PQRI Incentive Funds
PQRI was created to help physicians, yet it seems so overwhelming that many practices leave that money on the table,” says Michael Nissenbaum, CEO of iMedica Corporation.
However, this is exactly the kind of work that electronic health records (EHRs) can do automatically, making it easier for practices to earn the 2 percent bonus without a lot of extra time or paperwork.
If you haven’t yet made the leap to an EHR, this might be the final push you need, tipping the cost-benefit equation toward computerized records. Bear in mind that PQRI was made permanent last year (although it’s only funded through 2010), and many observers believe that the program will not always be voluntary.
Esatblished in 2006
PQRI was first established in 2006. It offers incentives to Medicare providers to report quality performance measures. The PQRI program continues in 2010 with 175 measures. Physicians who report at least three of the measures applicable for their practice during the calendar year will receive a bonus of up to 2% of their total Medicare allowed charges for that period. To be eligible, measures must be reported at least 80% of the time for patient encounters where a measure applies. The incentive is awarded for reporting on applicable measures whether or not the measure was met.
- Essentially, professional services paid under the Medicare Physician Fee Schedule (PFS) and billed directly to Medicare are covered. Eligible providers are those who bill according to the PFS, including physicians, dentists, and chiropractors; skilled practitioners such as PAs, NPs, registered dieticians, and audiologists (a new addition in 2009); and therapists such as physical and occupational.
- There’s no longer any need to sign up or pre-register to participate. Submitting quality data codes (either CPT II or G-codes) to CMS through claims or a qualified registry will indicate that you intend to participate.
Reporting PQRI:
Reporting these measures is where the actual work occurs and this is where an EMR program can help. The EMR should already contain all of the necessary data. A well-designed EMR—especially one that integrates disease management protocols—should be able to print the necessary documentation with minimal effort. There’s no reason for physicians to leave PQRI bonuses on the table. With the EMR systems available today, that 2 percent is surprisingly easy money.