The traditional fee-for-service model is quickly giving way to a new and exciting healthcare standard. The Physician Quality Reporting System (PQRS) has proven instrumental in this transition, offering the financial incentives necessary to convince medical professionals to ditch their usual approach to healthcare. Under PQRS, Eligible Professionals (EPs), are promised significant incentives in exchange for their commitment to prompt reporting of necessary information. Issues related to PQRS eligibility have left many interested parties confused since the program's adoption, with members of group practices especially curious about their standing. It is possible for group practices to take advantage of PQRS, but they must first meet a handful of stipulations. Once these conditions are achieved, approved group practices enjoy access to incentive payments similar to those available to individual EPs.
Benefits Of PQRS Enrollment
PQRS holds obvious benefits for isolated EPs, many of whom may otherwise struggle to get by in the current economic climate. But group practices also stand to benefit from PQRS enrollment, assuming they abide by the strict rules for reporting. For an approved group practice, the reward for satisfactory reporting is an incentive payment amounting to a selected percentage of the practice's estimated Medicare Part B Physician Fee Schedule charges. In addition to the basic monetary incentives, group practices participating in PQRS are able to improve their standard of care, while preparing for future reporting challenges in the rapidly-changing world of healthcare.
PQRS Enrollment Requirements For Group Practices
In order to qualify for PQRS incentives, group practices must agree to a number of stipulations, including the posting of measured PQRS performance on the Physician Compare website and the willingness to comply with secure data submission practices. Additionally, participating group practices must already possess the needed technological specifications for the program, including the presence of Microsoft Access and Microsoft Office.
Although group size does not determine whether a particular practice is eligible for PQRS incentives, practices are required to disclose this information while enrolling for the program. The sizing categories for PQRS include 2-24 EPs, 25-99 EPS and over 100 EPs.
Reporting Systems For Group Practices
While enrolling for PQRS, each group practice is required to select a preferred reporting system. Group practices tend to be better equipped for a variety of reporting systems than single EPs, so a greater measure of consideration may need to be applied to this important decision. Many group practices prefer to utilize Group Practice Reporting Option (GRPO) web interfaces, as these may also satisfy requirements for the Medicare Electronic Health Reporting Incentive Program. In order to take advantage of the web interface option, a group practice must include over 25 EPs.
Group practices lacking efficient EHR setups often opt for PQRS Registry Reporting. A new and increasingly popular option involves the Centers for Medicare and Medicaid Services (CMS) Certified Survey Vendor, which allows for reporting through the CG CAHPS survey. As with the online interface, the CMS Certified Survey Vendor option is only open to practices with 25 or more EPs.
The pay-for-performance healthcare option is increasingly becoming the preferred approach among a variety of group practices, meaning that, in the near future, the usual fee-for-service method may no longer be the standard for healthcare billing. PQRS is currently ushering in this new age of performance-based payments, opening up the incentive program to a variety of group practices. Although participating practices must content with sometimes complicated reporting stipulations, they are rewarded with significant financial incentives and quite possibly, a better standard of patient care.