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        ^{Consortium for Universal Health System Metrics}

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Specialty
PQRS Solutions

Medicare Providers
Mental Health
Therapists (OT/PT)
Dieticians
Podiatrist
HIE
Patient Adherence

Our QCDR Process

Summary of CMS reporting system

PQRS is CMS's system to assess healthcare eligible providers (EP) -

1. PQRS = Physician Quality Reporting Service
2. EP includes MD, DO, NP, PA, RN, among other healthcare professionals identified by NPI
3. EP's submissions are identified by NPI - National Provider Index, and TIN of reporting organization
4. PQRS will initially reward EPs ~$5B for compliance (1) and
5. PQRS will penalize EPs ~$10B (2%) for non-compliance (1) , and
6. Penalties increase annually.  Incentives disappear after first two years.
7. Over time, PQRS reporting methods will increase breadth and depth of assessment process.
8. Specialized HIT (health IT) will be necessary to fulfill PQRS mandates.
9. PQRS is legislated, in final rule, implemented and documented - search via keywords CMS PQRS QCDR.

 
 PQRS submission methods 

1 - "PQRI (PQRS predecessor) Claims" - 2007

Eligible providers (EP) adds QDC (quality data codes) to CMS Part B bills &
Submits annual QDC compilation Claims submission to CMS

2 - "PQRS Registry" - 2008

EP annually reviews charts of relevant patient population(s),
Send chart summaries to Registry,
Registry compiles & sends composite Registry submission to CMS

3 -  "PQRS EHR" - 2012

EP's computer (EMR/EHR...) compiles PQRS electronic chart summaries for relevant patient population(s)
EP's computer sends EHR submission to CMS 

4 -  "PQRS DSV" - 2012 - DSV - Data Service vendor

EP's computer (EMR/EHR...) exports raw electronic clinical data for relevant patient population(s)
EP's computer sends raw clinical data to DSV
DSV compiles electronic chart summaries into PQRS format 
EP's computer sends DSV submissions to CMS 

5 - "PQRS QCDR" -2014 - "Qualified Clinical Data Registry"

Have EP computer deliver summary electronic chart summaries to QCDR (usually a Medical Society)
QCDR compiles composite report,
QCDR reviews & sends composite QCDR submission to CMS
 

1. See other pages for online references
   
   http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html
   
   http://www.njhitec.org/pqrs/submission-methods/
   
    

(1) Incentive reward from CMS occurs during the reporting current , Penalty/disincentirve occurs TWO years after reporting year

year http://www.successehs.com/item/how-to-choose-a-pqrs-submission-method.htm
 

>  Our CMS Submission Private Cloud has generated 2012 PQRS and eRX reports
          that have achieved the following:    

           All PQRS and eRX reports were fully vetted by CMS

           Our fully functional CMS report subsystems have delivered results
                       to Qualified CMS Closed Data Service Vendors

           We have met tight deadlines.  (PQRS report generator development time: 3 months)

           We successfully integrated our processes with the client's IT infrastructure

           We minimize the burden to providers through efficient data migration

           We achieved maximum efficiency by applying staged data validation and vetting processes.    

For more information, contact us via email at clientservices@cuhsm.org

Universal Health System Metric Tools referenced on this site:
CMS Submission Toolkit, CST-CMS Submission Template, PQRS Audit Tool, PQRS Validator, GPRO Aggregator,
    QCDR-HISP and NwHIN Sleuth are trademarks of CMS Gateways, LLC
All other products mentioned are registered trademarks or trademarks of their respective companies.

QCDR-HISP = Qualified Clinical Data Registry - Health Information Service Provider

Questions or problems regarding technical problems for this web site should be directed to webmaster@cuhsm.org
Copyright © 2012-2014. All rights reserved.
Last modified: Friday October 31, 2014.