CMS-Approved PQRS Solution

Since the advent of the Centers for Medicare & Medicaid Services (CMS) voluntary Physician Quality Reporting System in 2007, the range of allowable reporting measures and the financial reimbursement percentage has consistently grown. Don’t leave money on the table. Our solution has never made it simpler.

The PQRS program was established by the 2006 Tax Relief and Health Care Act (TRHCA) (P.L. 109-432) which provides an incentive payment for eligible professional (EPs) who satisfactorily report data on specific quality measures. More information regarding these measures, and the specific definition of an EP, can be found on the CMS PQRS website.

Greenway’s integrated EHR, practice management and interoperability solution PrimeSUITE®, currently provides the optimal quality data and exchange necessary for PQRS reporting. In addition, through PrimeDATACLOUD™ we deliver on-demand services that help providers effectively manage daily operations with a complete analytic platform for clinical reporting on PRQS.

Based on Medicare patient populations and selected reporting criteria, participating Greenway customers have received from between $10,000 and $70,000 each through the CMS quality reporting program. PQRS incentives of 0.5% remain available until 2014; and then beginning in 2015, those who don’t meet requirements will be subject to payment adjustments of up to 2% in 2016 and beyond.

Key benefits

  • Report upon CMS’ allowable reporting measures and all measure groups
  • Adaptability to 2010 CMS provisions providing reporting to individual eligible professionals and group practices
  • Automated compilation and scrubbing backed by alerts for internal review prior to transmission
  • Elimination of manually matching CPT codes to reporting measures, allowing the use of existing clinical data methods
  • Customized accounts per eligible professional automating upload of your specialty measures
  • One-time annual submission compilation
  • Ability to separate the PQRS submission from billing functions for further streamlining at the front end

Greenway aids customers with two incentive pathways: Qualified Registry and EHR Data Submission Vendor (DSV) method.

Registry reporting — for which Greenway has several certifications — allows providers to select from 259 quality measures; and 241 of these measures are reportable via claims and/or registry, including 51 EHR-based measures.

The DSV method allows for submission of the PQRS measures data to CMS in the CMS-specified format(s) on the provider’s behalf. Eligible professionals who choose to report on EHR measures must report on a minimum of three measures for Medicare Part B beneficiaries at an 80% reporting rate to be able to qualify to earn a PQRS incentive payment.

Additionally, CMS now allows for a group reporting option for two or more eligible professionals, which now allows for smaller sizes to participate as a group. However, to receive an incentive, group practices must report via a registry.

PQRS measures currently align with the Medicare meaningful use incentive program through the clinical quality measures. It’s also possible for providers to participate in both the meaningful use and PQRS incentive programs. However, providers participating in PQRS cannot earn both an ePrescribing incentive and an EHR incentive payment.