A problem that The Centers for Medicare and Medicaid services often encounters regards the calculation and payment of financial incentives for an individual physician who satisfactorily reports PQRS (formerly PQRI) quality measures but is part of a group practice that files under one NPI and TIN.
CMS recently updated the solution to that problem, which was originally published in 2007 in the FAQs section of their website. Satisfactory PQR will be assessed by each individual eligible professional who is part of an NPI/TIN, using the individual-level NPI. The individual incentives earned by members of a group practice will be combined and paid to the TIN under which the claims were submitted. Therefore, whether one or several physicians file satisfactory PQR, the entire group will receive the incentives.
As our last blog post (about PQRS paying off for physicians) reported, nearly 120,000 physicians in more than 12,000 practices received payments from the Physician Quality Reporting System (PQRS), for a total of $234 million in 2009. Stronger participation in PQRS also gives CMS better information about the quality of care for patients in the U.S. and can therefore help improve care for all patients.
Although your entire practice will benefit from just one member turning in satisfactory PQR, it would be even more beneficial—for the practice, the medical field, and for patients seeking care—if every member of the practice participates in PQRS.
Integrated Data Management Services (IDMS) assists Dallas/Ft Worth physicians in capturing benefits of PQRS by identifying and correcting problematic areas. Through data abstraction and analysis, hospitals and physician offices can cut costs, improve quality of care, and reduce risk. Once the data is compiled, IDMS will develop a training and implementation strategy to improve compliance. Contact IDMS today at (972)922-9800, or email us at email@example.com to schedule a consultation.