Melissa Francisco of the American College of Rheumatology (ACR) does not mind taking time after regular working hours to help office managers who are confused about points of compliance with the Physician Quality Reporting System (PQRS). The head of registries at the ACR, Ms Francisco knows that part of her job means offering 24-hour support for the hundreds of ACR members’ practices who use the organization’s electronic PQRS reporting support.
“I and my coworker Natalie Fisk keep very flexible hours. Physicians and their staff have crazy schedules and sometimes may need to talk to us outside of the regular workday,” Ms Francisco told Value-Based Care in Rheumatology. “Our role is to work with ACR members whenever they need us to help them figure out how to report and the best method for them to use to report, as well as any of the details of each reporting process.”
Ms Francisco and Ms Fisk help ACR members navigate electronic reporting of PQRS data, because, as the Centers for Medicare & Medicaid Services (CMS) has documented, reporting the data electronically results in a higher compliance rate. CMS is working to ensure that providers get the message that accurate reporting is important: the incentive payment for successful reporting in 2014 is 0.5%; the payment will be assessed in the fall of 2015. Beginning in 2015 there will also be a 1.5% payment adjustment for clinicians who do not satisfactorily report data on quality measures for covered professional services. This will increase to 2% in 2016.
In addition, a provision came into effect this year that measures for patients with rheumatoid arthritis (RA) can no longer be reported as a group in claims-based reporting. This will help nudge even more practices toward electronic PQRS reporting, said Ms Francisco: practices that use claims-based reporting have to report on 9 measures for 50% of patient encounters, rather than the 6 in the RA measures group that are required to be reported on by providers submitting data electronically.
The 6 RA measures that are required to be reported in PQRS are as follows: documentation of which adult patients with RA have been prescribed disease-modifying antirheumatic drugs (DMARDs), as well as date and dose prescribed; whether these patients had tuberculosis screenings before biologic DMARD initiation; whether patients with RA had a yearly assessment of disease activity, functional status, and disease prognosis; and which patients have been prescribed prednisone and whether, if they have been receiving doses of at least 10 mg daily with no change or improvement, there has been documentation of creation of a steroid management plan within 12 months.
Ms Francisco gave Value-Based
Care in Rheumatology a virtual tour of the ACR Rheumatology Clinical Registry (RCR), which was launched in 2009. The website is designed to help practice staff members easily and quickly record and correct or update annual patient information relating to the 6 RA measures. The website also automatically generates reports that show where each practice stands with respect to other rheumatology practices in reporting of the 6 measures.
Ms Francisco and Ms Fisk also run 3 validation checks on each practice’s patient data, and send each practice a report that flags information that needs to be updated or corrected before the data are filed with the CMS. This service is available for a fee.
ACR staff launched a new system they have dubbed RISE—Rheumatology Informatics System for Effectiveness—that pulls data for PQRS reporting directly out of electronic health records. This means the intermediary step of entering the data into the RCR will not be needed. The ACR recently attained Qualified Clinical Data Registry status for this system.
“RISE is a single solution for meeting multiple reporting requirements, from filing for quality-based incentive programs to avoiding penalties,” said Ms Francisco. “The ACR is committed to providing products and services designed to streamline complex reporting processes, and ultimately advance the field of rheumatology.”
Last modified: May 21, 2015