Health Information Management

News: 2014 PQRS data available to public

CDI Strategies, January 14, 2016

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CMS recently expanded the amount of data available on its Physician Compare tool, to include new quality performance data was added for group practices, Accountable Care Organizations, and, for the first time, individual providers. However the AMA expressed concerns, calling the new data “incomplete and potentially inaccurate.”

The AMA said in a statement that the organization is concerned over the increased scope of data being made available to the public. The 2014 PQRS has widespread accuracy issues that have not been sufficiently addressed, the statement says, and the new quality information is not comprehensive.

Only 40,000 providers have complete PQRS data available, due to data problems that excluded a significant number of providers. The AMA stresses that consumers need to be aware that the absence of data on the Physician Compare tool is not necessarily a reflection of deficiencies in a physician’s quality of care. Although CMS does include a disclaimer on the Physician Compare website, the AMA believes the disclaimer is not visible enough.

The data is taken from the 2014 PQRS calculations. CMS believes this data will help patients make informed choices about their providers, encourage EPs to maintain high quality service, and will lead to overall improvements in healthcare, according to CMS’ press release.

The 2014 data now available on Physician Compare includes:

  • PQRS performance scores for preventive care, diabetes, cardiovascular, and patient safety
  • Patient experience feedback data from the Consumer Assessment of Healthcare Providers and Systems for PQRS
  • Quality of care measures for healthcare professionals
  • Updated ACO performance measures

Physicians who choose not to participate in PQRS face a payment penalty, which CDI specialists should be aware of and mention in physician education. Physicians who did not participate or did not meet quality standards in 2014 will receive a 2% payment reduction in 2016. The 2015 Medicare Physician Fee Schedule Rule finalized CMS’ proposal to base 2017 penalties on 2015 PQRS reporting. More information on PQRS, including payment adjustment information and a PQRS listserv, is available from CMS.

Editor’s Note: This article was adapted from Physician Practice Insider

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