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New regulations New programs New penalties
Healthcare leaders must oversee their EPs’ quality outcomes. From an executive’s perspective, simply keeping track of these reporting programs for all types of different providers can be overwhelming. From a provider’s perspective, it’s easy to see such programs as a complete distraction from the practice of medicine.
Through quality cycle management, Premier is your single solution for regulatory reporting and performance improvement to drive high-value care through well-defined metrics with targets, a firm culture of accountability, and deep executive engagement.
The quality of care delivered by individual Eligible Professionals (EPs) has never been more closely analyzed nor more critically tied to your organization’s financial health.
• Beginning in 2014, the Physician Quality Reporting System (PQRS) levied a penalty on all EPs who failed to successfully report approved quality measures.
• Additionally, all organizations with 10 or more EPs will be subject to the value-based payment modifier (VM) which presents a financial impact on providers’ incentive payments based on cost and quality performance of the reported PQRS measures in 2015.
• At the same time, if EPs are unable to demonstrate meaningful use (MU), there will be additional penalties. In 2016, all non-physician EPs will join physicians and will also be impacted by the VM.
The impact of these three provider-based quality programs in can lead to substantial penalties.
2015 performance dictates 2017 payment. Be ready.
PROVIDER REGULATORY SOLUTIONS
TRANSFORMING HEALTHCARE TOGETHER®
Premier’s CMS-approved Qualified Registry and Qualified Clinical Data Registry (QCDR) allows all healthcare leaders to identify improvement opportunities in both cost and quality to mitigate payment penalties and improve patient care. The Premier Clinical Performance Registry Program is uniquely positioned to help you identify quality improvement opportunities and mitigate penalties via real-time monitoring through on-demand reports and subject matter experts who understand how to navigate the multiple programs. Additional benefits include:
• Avoiding PQRS, VM and MU penalties;
• Ability to select measures that truly depict the performance improvement of your providers, including readmissions, inpatient mortality and average length of stay;
• Alignment of provider measures crossing various care settings, thereby creating shared goals for both hospital and providers;
• A systematic view to quality and financial outcomes;
• The ability to report – agnostic to your electronic health record – on measures that span multiple specialties and all payers;
• The ability to track meaningful benchmarks on provider performance;
• Administrative access to on-demand individual, peer and facility level reports;
• On-demand Web-based performance dashboards with real-time performance; and
• Collaborative activities to foster peer-to-peer sharing of best practices.
Reporting your data – Leverage the Premier Clinical Performance Registry™ Program
Navigating the variety of reporting programs for providers is complex. For performance in 2015 and payment in 2017, groups of 10 or more eligible professionals are at risk for as much as 9 percent of payment!
• 2 percent for failure to submit under PQRS;
• 4 percent for the VM if more than 10 EPs; and
• 3 percent for failure under meaningful use.
Through assessment, education and performance improvement planning, Premier can help minimize the reporting burden on EPs through more effective clinical documentation, coding and technical integration, specifically during a time when ICD-10 will be implemented.
Premier’s PQRS advisory services offers the flexibility to tailor a PQRS consulting solution to your organization. Premier can also provide the following support to a PQRS program:
• EP education;
• Measure selection;
• Recommendations for PQRS reporting options;
• Development of data collection and submission processes; and
• Identification and support of performance improvement activities.
Improving your scores – Physician Quality Reporting System (PQRS) advisory services
Start by making the move to the Premier Clinical Performance Registry Program TODAYIn February, Secretary of Health and Human Services Sylvia Burwell announced her goal to move Medicare payments to 90 percent value-based payment systems and 50 percent alternative payment mechanisms by 2018. These programs all rely on quality measure reporting.
While the Medicare Access and CHIP Reauthorization (MACRA) of 2015 will combine these programs starting in 2019, the fundamental underpinnings remain the same and 4 to 9 percent of EPs payments will be at risk over time. The law not only strengthens the quality reporting requirements and encourages the use of QCDRs, but also expands reporting to clinical practice improvement activities such as expanded access, patient safety, and population management.
The requirement for EPs to report quality measures is here to stay, and it is growing exponentially. It is crucial for providers and healthcare leaders to understand the PQRS, VM and MU programs to develop a strategy that successfully reduces costs while improving quality. Don’t wait for the CMS penalties to be levied.
TRANSFORMINGHEALTHCARE TOGETHER®
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T 704.357.0022
444 N Capitol Street NWSuite 625Washington, DC 20001-1511
T 202.393.0860
PREMIERINC.COM
Contact Premier now to identify high-risk performance areas and develop a robust quality improvement and reporting strategy.
PLEASE CONTACT: Lori HarringtonDirector, regulatory solutions
Michele BackPrincipal, quality and safety
Paul GreenPrincipal, quality and safety
@PremierHA
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About Premier, Inc.Premier, Inc. (NASDAQ:PINC) is a leading healthcare improvement company, uniting an alliance of
approximately 3,400 U.S. hospitals and 110,000 other providers to transform healthcare. With
integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services,
Premier enables better care and outcomes at a lower cost. Premier, a Malcolm Baldrige National
Quality Award recipient, plays a critical role in the rapidly evolving healthcare industry, collaborating
with members to co-develop long-term innovations that reinvent and improve the way care is
delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about
transforming American healthcare.
