Physician Quality Reporting System

2016 PQRS program overview

The Physician Quality Reporting System (PQRS) is a Medicare reporting program. PQRS requires doctors of optometry and other health care providers to report on quality measures that relate to various clinical actions.  By reporting PQRS quality measures, health care providers are able to quantify how often they are meeting particular quality metric.

Please note: Measure #173 (Preventive Care and Screening: Unhealthy Alcohol Use - Screening) has been removed from PQRS for 2016.

2018 Payment Penalty
Doctors of optometry that treat Medicare patients and choose not to participate in PQRS will be financially penalized. Doctors of optometry who do not participate in 2016, will have their Medicare payments reduced by 2% in 2018.

PQRS and AOA MORE Starting in January 2016, AOA MORE will collect your PQRS data for one full year. This means in 2016, PQRS data will be sent to AOA MORE (automatically done through your EHR integration on a weekly basis).

If you join AOA MORE after January 1, it has been programmed to identify your PQRS documentation dating back to January 1 and you will still be able to submit one year of data (reporting for 2016 occurs by you any time during the first 60 days of 2017) even if you joined AOA MORE mid-year.

As long as you are using AOA MORE and submitting your data to AOA MORE, you will no longer need to do extra written codes (i.e., 2027F, 2019F, etc.), AOA MORE will do it for you and you will no longer have to report through your EHR system!

You will be required to formally "agree to submit" this data to PQRS when it's time to do so (for 2016 this occurs during the first 60 days of 2017), as that, too, is a requirement of CMS. AOA will notify doctors when it's time to report and remind all AOA MORE users of the deadlines.

Your EHR vendor will securely push your PQRS data to AOA MORE, which will then calculate your PQRS measures for you. Once the data is in the registry, you will simply review and formally approve the data for submission during the PQRS data submission period (typically January 1 to February 28 of the following year). Only then will AOA MORE submit the data to CMS on your behalf.  

CMS is moving PQRS in the direction (for EHR users) of using eCQMs as the reporting mechanism to satisfy PQRS. The eCQMs will make documentation easier for ODs. If you have taken the recommended clinical actions (i.e., documented the optic nerve findings on a glaucoma patient), it will automatically generate the appropriate required eCQM/PQRS data. AOA MORE is designed with your EHR vendor so that eCQMs are submitted to meet PQRS needs. Most EHR vendors have a worksheet to explain what data fields in the EHR correlate to the eCQM. Your AOA MORE dashboards will give you a snapshot of how you are doing with these quality measures over time.

 2018 Payment Penalty  

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