PQRS

[Spine Specialist]

Physician Quality Reporting System or -4% cut in 2017.
What you solo pain practitioners (Eligible Providers) or small group are planning to do? Any advice or input appreciated. Thanks!!

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[hyperalgesia]

Physician Quality Reporting System or -4% cut in 2017.
What you solo pain practitioners (Eligible Providers) or small group are planning to do? Any advice or input appreciated. Thanks!!

I'm completely ignoring it along with meaningful use. It's a quality of life issue for me. Traditional Medicare is about 25% of my practice so I may lose a max of 2-3% of my income. Of course I'd have to pay about 50% taxes (including state, FICA, etc), so that's really about 1-2% loss of real income. I use a really simple and free EMR that is a pleasure to use. It was not a tough decision at all for me.

 

[pastafan]

I'm completely ignoring it along with meaningful use. It's a quality of life issue for me. Traditional Medicare is about 25% of my practice so I may lose a max of 2-3% of my income. Of course I'd have to pay about 50% taxes (including state, FICA, etc), so that's really about 1-2% loss of real income. I use a really simple and free EMR that is a pleasure to use. It was not a tough decision at all for me.

What EMR do you use? This is the first time I have ever seen an EMR described in these terms.

 

[powermd]

We're doing it. We added a Medicare-only section to our intake form to collect some data, it's not that big a deal, but it is annoying. Only on E&M visits do you have to do it. There are measures that must be done at every visit, and others that are only once per year.

At every visit we do an NRS pain score, enter whether or not patients with a 715 dx of arthritis report functional loss, and attest to keeping an accurate med record. Once yearly we do a few other measures: BMI, balance, new fractures, and smoking. Oh.. and on procedures where 77002 or 77003 is billed, we indicate the fluoro time (turns out to only be hips, knees, and shoulders for us). I set up a template in our EMR to automatically enter the appropriate CPT codes as you do the data entry. It takes longer for the EMR to process all the data and pop it into the note than it does to physically enter. We use EMDs.

 

[hyperalgesia]

What EMR do you use? This is the first time I have ever seen an EMR described in these terms.

It's a non-commercial EMR program that I made, that's why I like it. There is not a single, unnecessary click in the program. It also electronically submits and actively monitors all my claims.

 

[SSdoc33]

t we do an NRS pain score, enter whether or not patients with a 715 dx of arthritis report functional loss, and attest to keeping an accurate med record. Once yearly we do a few other measures: BMI, balance

It's a non-commercial EMR program that I made, that's why I like it. There is not a single, unnecessary click in the program. It also electronically submits and actively monitors all my claims.

sell it to us

 

[nvrsumr]

We're doing it. We added a Medicare-only section to our intake form to collect some data, it's not that big a deal, but it is annoying. Only on E&M visits do you have to do it. There are measures that must be done at every visit, and others that are only once per year.

At every visit we do an NRS pain score, enter whether or not patients with a 715 dx of arthritis report functional loss, and attest to keeping an accurate med record. Once yearly we do a few other measures: BMI, balance, new fractures, and smoking. Oh.. and on procedures where 77002 or 77003 is billed, we indicate the fluoro time (turns out to only be hips, knees, and shoulders for us). I set up a template in our EMR to automatically enter the appropriate CPT codes as you do the data entry. It takes longer for the EMR to process all the data and pop it into the note than it does to physically enter. We use EMDs.

I have not been including fluoro times. This is a pqrs requirement?

 

[Pain Applicant1]

Physician Quality Reporting System or -4% cut in 2017.
What you solo pain practitioners (Eligible Providers) or small group are planning to do? Any advice or input appreciated. Thanks!!

Your EMR should be recording this for you. Just make sure your clicking the right buttons on it. You can choose which CQMs to choose from. It's not difficult once you understand it but getting through the bureaucratic language is a pain. CMS just toned down the requirements and made MU a bit easier. Read through the CQMs and pick the ones that are easiest to comply with. Print up some paperwork for the patients (e.g., depression screens) and scan into your chart for documentation. I believe CMS has 6 years to audit you.

 

[nvrsumr]

Thanks. I usually dont leave money on the table but after getting the original emr $ i may just say f*** it to pqrs/mu and take the hit. I have been trying to comply but not worth an audit.

 

[hyperalgesia]

sell it to us

I want to try to produce a demo of my EMR... It could be a good option for some. It does not interface with pharmacies or hospitals or patients. It only interfaces with payers. For follow ups, encounter info is imported from prior visit. CPTs are paired to your fee schedule. It will print a pdf of a clinical note, patient invoice, completed CMS1500, etc. It is HIPAA compliant, encrypted and web based. My scheduler logs with her access and schedules pts. There are no pop ups or reminders. There are no drug interaction warnings. It expects you to be a smart doctor. It laughs in the face of meaningful use...

 

[sbdoctor87]

I am doing a project against pqrs incentives, and Im wondering is this incentive only available till 2021???

Bc on this page https://www.cms.gov/regulations-and...mln_medicareehrprogram_pqrs_erxcomparison.pdf at the beginning of page 7.

The pqrs payout is only showed till 2021 and it keeps going down from each year and gives a negative number. So does that mean you will actually pay a penalty for being part of the program?

 

[Ducttape]

you pay a penalty for not doing PRQS. bonus until 2015, then amounts get garnished from medicare payments.

 

[drpainfree]

would be interested in your program, too

 

[Stim4me]

We're doing it. We added a Medicare-only section to our intake form to collect some data, it's not that big a deal, but it is annoying. Only on E&M visits do you have to do it. There are measures that must be done at every visit, and others that are only once per year.

At every visit we do an NRS pain score, enter whether or not patients with a 715 dx of arthritis report functional loss, and attest to keeping an accurate med record. Once yearly we do a few other measures: BMI, balance, new fractures, and smoking. Oh.. and on procedures where 77002 or 77003 is billed, we indicate the fluoro time (turns out to only be hips, knees, and shoulders for us). I set up a template in our EMR to automatically enter the appropriate CPT codes as you do the data entry. It takes longer for the EMR to process all the data and pop it into the note than it does to physically enter. We use EMDs.

we do the same as you have described. It is tedious. We have to click at least 4-9 measures every visit, which is mind numbing.... CMS may still fine our practices due to audits, ICD 10 documentation issues, clearinghouse missteps, etc. I will determine in a year or two if its worth the headache. If CMS continues to take back 2% every year in spite of all the eprescribing, pqrs, and icd 10 mandates, I'M out of medicare... good news is that our procedures went up 1% this year on average, therefore we are only getting 39% less money since 2009....

 

[hyperalgesia]

The future looks bleak with this new MIPS program, which apparently mates PQRS with Meaningful Use to create a Frankenstein that cannot be ignored. If this occurs, you can seriously count me out of Medicare.

http://www.saignite.com/resources/faq-about-merit-based-incentive-payment-mips