Report on PQRS measures now
If you haven't started participating in the Physician Quality Reporting System (PQRS) for 2014, time is running out to report on quality measures, earn a bonus and avoid penalties. The AOA encourages more ODs to participate in PQRS, which will likely be a key component of any future Medicare payment model.
Providers must report accurately on at least nine measures for 50 percent of their applicable patients to receive a 0.5 percent incentive payment in 2015. Those who don't participate at all face a 2 percent penalty in 2016. Reporting successfully on just three of the measures means you avoid the penalty-but won't earn a bonus.
The reporting period is for all of 2014, so there's no firm deadline to begin PQRS. However, most doctors should probably start reporting by the middle of the year if they haven't already—assuming they have a similar number of patients in the first half of the year and the second.
"It's important to begin now so that you can reach the 50 percent accuracy and cases required to meet the PQRS bonus goals," says Rebecca Wartman, O.D., member of the AOA Third Party Center Coding Committee. "If you wait until June but actually saw more Medicare patients between January and June who met the criteria to add PQRS codes, then you would not earn the 2015 bonus."
ODs have at least 10 PQRS measures to choose from:
- Three for diabetic patients
- Two for glaucoma patients
- Two for macular degeneration patients
- Tobacco use and counseling
- Hypertension and follow-up, and
- Medication listing
There is no sign-up required. ODs can immediately begin by reporting the quality data codes that correspond to the applicable quality measure on their Medicare claims.
OD reporting rates are on the rise
AOA research on 2012 PQRS statistics found that participation is on the rise, but there's room for growth:
- OD participation rose from 28.6 percent in 2011 to 32 percent in 2012; by comparison, ophthalmology grew from 46.6 percent to 55 percent
- ODs ranked 37th in participation rates out of 55 eligible specialties
- Optometry was the fifth-highest non-MD/DO specialty participating in PQRS
- ODs earned $1,810,832 in PQRS incentive bonuses, compared with ophthalmologists, who earned$15,921,621
Access the AOA's webinar on PQRS and other resources at eyelearn.aoa.org.