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Although not well-known among doctors of chiropractic, there is a report card called the Quality Resource Use Report (QRUR).
Medicare’s Physician Feedback Program provides comparative performance information to Medicare Fee-For-Service (FFS) physicians on participation in Medicare programs. And yes, as a doctor of chiropractic, you are in the program.
The QRUR is intended to provide feedback for Medicare enrolled physicians to understand the quality and efficiency of care provided to Medicare beneficiaries and inform physicians about their performance (as identified by their Taxpayer Identification Number or “TIN”) on a subset of measures that are currently included in the Value-Based Modifier (VBM).
To access your QRUR, click here. QRURs are provided for each Medicare-enrolled TIN). Note that you (or one person from your group) will need to obtain an Enterprise Identity Management System (EIDM) account. You can find more information and instructions here.
What does your QRUR mean?
What you will see on your QRUR is a subset of measures included in the VBM. The VBM is a budget neutral pay-for-performance program mandated by the Affordable Care Act. It is one of the three current performance categories that will sunset with the advent of the new Merit-based Incentive Payment System (MIPS).
Namely, MIPS will combine three quality incentive payment programs; the Physician Quality Reporting System (PQRS), the Value-Based Modifier (VBM), and Meaningful Use (MU) of Certified Electronic Health Records Technology (CEHRT) into a single quality incentive payment program, known as Medicare’s Quality Payment Program. A fourth performance category in MIPS, which is new to providers, is called Clinical Practice Improvement Activities (CPIA).
Beginning in 2016, doctors of chiropractic as solo physicians or as small group practices of 2–9 providers will be included in the VBM program. Those who do not successfully participate in PQRS in 2016 will receive an automatic 2-percent VBM deduction, in addition to the 2-percent PQRS deduction. Solo physicians and small group practices, who do successfully report to PQRS in 2016, are either subject to a neutral adjustment, a payment penalty up to 2-percent, or a positive payment incentive of up to 2-percent.
Putting it to use
Furthermore, CMS has a two-year lag, so your 2014 QRUR is how you performed on PQRS measures reported in 2014, affecting your 2016 reimbursement.
For instance, in 2014, doctors of chiropractic were required to report on three PQRS measures, #317 (preventive screening for high blood pressure), #131 (pain assessment and follow-up), and #182 (functional outcome assessment). Now in 2016, many of you likely already know that you are receiving a 2-percent penalty for not meeting the reporting requirements of 2014 (on the three measures noted).
Through the QRUR report, you will be able to see exactly why and how you performed on each of those measures. Also note that in the portal you will see there are previous-year reports; however, prior to 2014 the doctor of chiropractic data was not put into the QRUR. If you download your midyear 2015 QRUR, you will find it is empty and, according to CMS, the doctor of chiropractic will not have data available until September 2016 when your final 2015 QRUR is scheduled to be published.
It is recommended to keep your EIDM information up to date. So if you have any providers in your practice who have retired or are no longer seeing patients for any reason, you will want to update their status, allowing your report card to accurately reflect the participating NPIs under your TIN. You want to successfully report PQRS measures in 2016 and stay abreast of all of the changes occurring with MACRA law, as these new performance categories will be included in the QRUR for 2017 performance period and 2019 payment period. The final rule is expected to be published in November 2016.
Think of 2016 as a dress rehearsal for successfully reporting under the new MACRA law, which is proposed to begin in January 2017. Even in the event of a delay of the start of MIPS reporting, it will take time to prepare your practice to be successful, so use this time now wisely. Start by downloading your CMS report card—your—QRUR, today.
The QRUR will undoubtedly become another key performance indicator on your practice’s dashboard for years to come. It’s time to understand it and start using it. The opportunity to improve your reimbursement is on the horizon.
About Best Practices Academy
Providing leadership in practice growth, risk management, quality performance, and certified EHR systems since 2006. Best Practices Academy (BPA) will be sure your practice is ready to migrate from fee-for-service-based to a value-based system, and help you grow the practice of your dreams. BPA studies your practice’s statistics such as CPT codes being utilized, most common ICD-10 code selections, random review of documentation, capacity analysis, and financial account reports to determine if your practice is healthy or sick.
Best Practices Academy prides itself in having some of the best people in the industry to evaluate practices. A team approach is taken to find out what areas of concern are. This is usually an eye opener for many DCs.