Last week I mentioned a report CMS recently published describing its experience with PQRS and eRX over the last few years. This week let’s explore what CMS had to say about PQRS.
The report specifically examines the national reporting experience between 2008 and 2011. As most will recall, PQRS started in 2007 with 74 individual measures and claims-based reporting. Nationally, about 100,000 providers participated in 2007; 55,000 were successful. As the program evolved, several alternative reporting opportunities were developed, including registry reporting, group practice reporting (GPRO) and EHR reporting. In 2011, the number of successful providers reporting PQRS exceeded 260,000.
Nephrologists favor registry reporting
The GPRO and EHR reporting options have not impacted nephrology, in large part due to the limited measure reporting choices. Nephrologists continue to report via claims, but an increasing majority of nephrologists have turned to registry reporting. Registry reporting became available in 2008. The graph below displays the number of nephrologists reporting PQRS using the claims versus the registry method of reporting. While claims-based reporting remains stagnant among nephrologists, registry reporting continues to grow in popularity. Our experience with Acumen PQRS suggests this trend will continue
Reporting success
I think there are a couple of reasons why nephrologists have migrated to registry reporting. The first is convenience. In contrast to claims-based reporting, registry reporting permits the provider (or more commonly his or her office staff) to enter the PQRS data retrospectively, using either data collection sheets or a chart-audit approach to data extraction.
Registry reporting is especially popular among nephrologists because of its success rates. Using the most recent figures from the CMS report, nephrologists reporting individual measures or a measures group via claims in 2011 were successful at a rate of 57 and 44 percent respectively. In 2011, nephrologists reporting individual measures or a measures group through a registry achieved success rates of 86 and 96 percent respectively. This substantial difference in successful reporting translates to larger number of nephrologists receiving the PQRS incentive when reporting through a registry.
Outlook for 2013
What can we expect for this year? I think demand for registry reporting will continue to surge. The CMS report notes that slightly over 30 percent of the nephrologists registered with NPPES participated in PQRS during 2011. That figure is consistent with the national experience of physicians in 2011. Internally, we witnessed an increase in demand in 2012, which I found remarkable. In spite of the incentive dropping from 1.0 percent of the provider’s Part B allowable in 2011 to 0.5 percent of the Part B allowable in 2012, our registry experienced significant growth last year, and Acumen PQRS continues to be the market leader in the nephrology space.
For 2013 the incentive remains 0.5 percent; but remember, 2013 is the payment-adjustment reporting period for 2015. In other words, if you do not participate in 2013, you will face a 1.5% penalty in 2015. Without discounting the cash flows, it’s pretty clear that participating in 2013 is worth 2.0 percent of your Part B book of business. Of course if you believe in Prospect Theory, where losses loom larger than gains, participating in 2013 might be worth more than a 2.0 percent net gain for your practice. What are your plans for 2013? Respond to the survey and join the conversation.
[polldaddy poll=7068513]
Leave a Reply