For anesthesia practices participating in the Physician Quality Reporting System (PQRS) from CMS, there are four ways to take part: claims, qualified registries, electronic health records (EHR), and a fourth option known as qualified clinical data registries (QCDRs).
Most providers utilize one of the first three methods to submit data to CMS. However, there is still a degree of uncertainty involved with these methods, and really any claim-based reporting method.
That is why anesthesia providers are beginning to move toward QCDRs as a way to fully participate in PQRS. Here, we’ll outline the general concept of QCDRs and how to take part in this system.
CMS describes a QCDR as a “CMS-approved entity…that collects medical and/or clinical data for the purpose of patient and disease tracking to foster improvement in the quality of care furnished to patients.” CMS further clarifies a “CMS-approved entity” as a registry, certification board, collaborative, or other entity.
QCDRs collect data on quality measures – like the ones stipulated by CMS in their latest update to PQRS – and submits this data on a provider’s behalf to CMS. Data collected during performance year 2016 will be submitted to CMS during the first quarter of 2017.
There are a few noticeable differences between using QCDRs and using other reporting methods. When using claims, for example, providers must report nine PQRS measures from three NQS (National Quality Strategy) domains. In addition, they must report a cross-cutting measure if applicable, on at least half (50%) of their Medicare fee-for-service patients.
With QCDRs, however, professionals must report the same nine measures including two outcome measures on at least half of all patients. These outcome measures focus on the outcome of health care, versus the process behind care. This is due to a shifting emphasis on quality of health care – rather than processes – from CMS.
As mentioned, one of the biggest differences between a QCDR and qualified registries is the fact that with QCDR, you have to report on half of all of your patients, even those with private insurance. Additionally, you don’t have to report a cross-cutting measure; the two outcome measures replace that particular component (and can be a part of your nine reporting measures).
Benefits of QCDRs over Other Reporting Methods
One benefit of reporting via QCDRs is flexibility. Those reporting via qualified registries can only choose from an approved list of PQRS measures. With QCDRs, however, a provider can choose from PQRS measures and non-PQRS measures – hence making it easier to fulfill all reporting requirements.
Another benefit is ease-of-use. QCDRs are becoming known for how easy they are to use relative to other methods. Practices are discovering that the reporting burden – 2.6 hours per week on quality reporting, on average, per physician, according to an MGMA survey – is lower with a QCDR than with the alternatives.
The state of health care is constantly changing and evolving. The evolution of reporting from the old way to the newer methods (focused on quality of care and patient satisfaction) necessitates change, and practices that get on board now, rather than later, will reap the benefits.
To learn more about how QCDRs are tied into a practice’s anesthesia billing and coding, contact MBM.