Align PQRS and CQMs in 2014

Ask Joy: Align PQRS and CQMs in 2014

By Joy Rios, Managing Partner at Practice Transformation
Twitter: @askjoyrios

Did you know there are 13 different ways to report PQRS satisfactorily? In a previous Learning Lunch webinar we discussed some of the more convenient ways to participate in the program, starting points for practices just getting on board, and advise on how to avoid the 2015 penalty. We also spent some time talking about how to use the same measures to report both PQRS and CQM data for the EHR Incentive Program. But some great follow-up questions about the the overlap of these two programs trickled in that are worth sharing too.

Below is a screen shot from the CMS 2014 CQM Tip Sheet. You will see the highlighted area states a provider can choose to report CQM’s on either a year or the same 3-month reporting period as their MU.

2014 MU

If the provider chooses the 3-month reporting period for CQMs in 2014, does she also have to report a full year of PQRS?

Yes, even though the EP may only be reporting 3 months of CQM data, she will still have to report a full year of PQRS data. If the EP chooses the same measures to report for both programs, then she will need to report a total of 9 measures for a full calendar year to meet the requirements for both programs. If the EP chooses to report different measures for both programs, then it would mean reporting 9 measures for CQMs for 3 months, and 3 individual measures (or 1 measures group) for a full calendar year for PQRS. This method would mean they submit the data separately.

What is the submission method they will use to report the CQMs for MU vs. PQRS?

It depends. If the EP chooses to report CQM & PQRS data together, she can choose from two reporting methods from the PQRS Medicare EHR Incentive Program Pilot to submit data for both programs. However, if she chooses to report them separately, then the CQMs would be reported electronically following the specifications outlined in these resources, and PQRS can be reported in any of the available options (e.g. claims, registry, EHR, GPRO). More information on the traditional ways of reporting PQRS data can be found here.

Will they receive their MU Incentive money right away (within 6-8 weeks) or will it come in 2015?

If the EP reports CQMs & PQRS together, the incentive money will arrive in 2015. The MU incentive would come in spring 2015, and the PQRS incentive would arrive around September 2015. However, if they report separately, the MU incentive would arrive in the 6-8 week timeframe and the PQRS incentive would arrive around September 2015.

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When: 12pm ET/11am CT, July 30, July 31, August 6, and August 7.

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Ask Joy is a regular column on 4Medapproved HIT Answers and is syndicated here with permission.