PQRI Basics
PQRI (Physicians Quality Reporting Initiatives) is a voluntary reporting initiative tied to services
given to Medicare Part B recipients. The program runs through end of calendar year 2010. Medicare will pay program incentives through 2010. Incentives are described in more detail below.
PQRI has established procedural checklists for patient treatment in the following categories:
| • Diabetes Mellitus |
• Rheumatoid Arthritis |
| • Chronic Kidney Disease |
• Perioperative Care |
| • Preventive Care |
• Back Pain |
| • Coronary Artery Bypass Graft |
• See A Sample PQRI Checklist |
Doctors participate by submitted a list of check-listed items they do and do not perform during each patient encounter. Doctors may submit data to Medicare via bills (using special billing codes) or via a certified process designed specifically to collect PQRI data. Submissions are due within 60 days of calendar year end.
Do You Need an EMR System to Participate In PQRI?
No.
Some EMR systems facilitate automated data collection and submission, but
you do not need an EMR system to participate in this program.
PQRI provides for manual collection and reporting. If you use an electronic billing service, it may facilitate PQRI participation either by providing all necessary data services or by furnishing you with structured reports (e.g. spreadsheets or comma delimited data) that you can use to make submissions.
PQRI offers participants several choices about the amount of data they collect and the length of collection periods. For more information, see
A Step-By-Step Guide [for Enrolling] in the Physician Quality Improvement Initiative.
PQRI Links and Resources
We've developed work templates to help our clients manually collect and manage PQRI data.
Follow this link to learn more.
The HHS
web site provides detailed information about subsidies and instructions for PQRI participation. We've also found several excellent articles on the web. We've listed our favorites below.
Read This First: A Step-By-Step Guide [for Enrolling] in the Physician Quality Improvement Initiative. By Michael T. Rapp, MD, JD, FACEP, Centers for Medicare and Medicaid Services. As published 2009 in
ModernMedicine.com.
HHS CMS Programs and Information home page. (Health and Human Services, Center for Medicare & Medicaid Services) .
Getting Started With 2009 PQRI Reporting of Measures Groups.
Sample codes and sample bills used in the PQRI reporting process. From HHS's Centers for Medicare and Medicaid Services.
The HHS CMS Frequently Asked Questions.
Searchable answers to 191 FAQs about PQRI.
Sample Manual Data Collection Sheet.
Developed by ASCRS (American Academy of Cataract And Refractive Surgery). From
www.ASCRS.org's PQRI home page.
More to come...
