CMS has announced alternative reporting periods and reporting criteria for the 2008 Physician Quality Reporting Initiative (PQRI).
PQRI provides bonus payments to practitioners who satisfactorily report on CMS-approved measures on a variety of topics, such as RA, osteoporosis, osteoarthritis, and pain management.
There are now nine possible reporting options—including claims- and registry-based reporting of individual measures and measure groups—for six- or 12-month reporting periods ending December 31, 2008. Three of the nine possible reporting options apply to rheumatology practitioners (the other six use measure groups that include non-rheumatology measures):
- Report through claims for January 1–December 31, 2008
- Report through registry for January 1–December 31, 2008
- Report through registry for July 1–December 31, 2008
The second and third options are contingent on the registry being on the CMS-approved registry list that will be posted on the CMS Web site by August 31, 2008.
There is no half-year claims-based individual measure reporting option. The half-year reporting possibility only applies if providers use a registry or if they report the largely non–rheumatology focused measure groups through claims. However, practitioners who did not begin claims-based reporting in early 2008 may still be able to successfully participate in full-year individual measure claims-based reporting by using measures that require reporting only once per year. Examples include measures #4 (screening for falls risk), #39 (osteoporosis screening), #41 (osteoporosis: pharmacologic therapy), and #108 (RA DMARD use).
Measures that must be reported after each visit should not be started mid-year because practitioners would likely not meet the minimum annual reporting requirements. Examples include measures #24 (osteoporosis: post fracture communication), #40 (osteoporosis: management following fracture), #109 (osteoarthritis functional assessment), #124 (electronic health records), and #125 (e-prescribing).
More information on PQRI and these recent changes is available at www.cms.gov/pqri.