3 tips for earning PQRS bonuses

Earning a yearly bonus for reporting on quality measures requires diligence—and overcoming IT challenges.

The profession has one of the highest participation rates of non-MD providers.

So far, optometry's interest in Medicare's Physician Quality Reporting System (PQRS) program has been robust. The profession has one of the highest participation rates of non-MD providers, says Rebecca Wartman, O.D., member of the AOA Third Party Center Executive Committee.

In 2012, the last year in which data was available, optometrists reported 2,879,372 codes—and reported them correctly nearly 87 percent of the time, Dr. Wartman says. Below, practicing ODs share insight on how to make the most of the program.

1. Be diligent when you're busy.

The key to success is not to be complacent about reporting, says Steven Eiss, O.D., of Pennsburg, Pa. Dr. Eiss' practice has consistently earned PQRS incentives, ranging from just over $500 to more than $1,800 annually, since the program first began in 2007.

"The biggest challenge is forcing yourself to do it when you're seeing patients and you're busy," Dr. Eiss says. PQRS is all about getting grades on the quality of patient exams, so doctors should take ownership of these measures, he adds.

2. Understand IT.

Maria Santullo Richman, O.D., of Manasquan, N.J., has participated in PQRS since 2008, and all three doctors in her practice have earned incentives.

Dr. Richman says working with electronic health record vendors to report on measures has posed the biggest challenge. Participants have several options for reporting PQRS data: through claims, a certified electronic health record, group practice reporting, or through a qualified clinical data registry.

"The office can document, document, and document, but if the right button isn't clicked or the right sequence isn't followed, the systems don't record it appropriately," she says. Attention to detail is crucial.

Dr. Eiss' practice uses a screening process that automatically draws up PQRS codes and makes the reporting process easy. At the end of a patient visit, the ODs pick the codes they want. "If we have a diabetic patient, we choose the diabetic codes," he says. "If we have glaucoma, we choose the glaucoma codes."

3. Know the new reporting requirements.

This year's PQRS program steps up reporting requirements for providers. The bonus remains the same—0.5 percent—but providers have to report accurately on at least nine measures at least half the time to earn it. That's up from three measures in recent years, Dr. Wartman says.

Currently, there are seven PQRS measures specific to eye care: three for diabetic patients, two for glaucoma patients and two for macular degeneration patients. Additionally, ODs can report on tobacco use and counseling, hypertension and follow-up, and medication listing.

Providers who don't participate in PQRS at all in 2014 will be penalized 2 percent in 2016. Those who report successfully on just three of the measures can avoid this penalty—but won't earn a bonus.

Dr. Richman notes her office will have to make some adjustments to accommodate the new measures. "It will change the way that we record our findings, but we will remain involved in PQRS."

Visit www.aoa.org/hcr to master PQRS reporting.

April 9, 2014

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