The 2008 Physician Quality Reporting Initiative (PQRI) continues to provide a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from January 1 to December 31, 2008, may earn a bonus payment, subject to a cap, of 1.5 percent of total allowed charges for covered Medicare physician fee schedule services.

ASH Participation in Performance Measures

In 2005, Congress and the Centers for Medicare and Medicaid Services (CMS) became increasingly interested in developing a pay-for-performance (P4P) program for physicians treating Medicare beneficiaries. In part, Congress believed that it could achieve significant savings in the Medicare program by improving quality of care and consequently reducing hospitalizations. Following the approval of the Executive Committee, the Committee on Practice created a special task force to devise formal criteria for hematology-related performance measures. The Task Force worked closely with CMS to develop appropriate quality measures for hematology and submitted five draft measures to the agency for review. Ultimately, four hematology-related quality measures developed by ASH were approved and included in PQRI. In addition, there are two measures dealing with health information technology for which your practice may qualify.

ASH participates regularly with the Ambulatory Quality Alliance, National Quality Forum, and American Medical Association-Physician Consortium via the Hematology Work Group, and has membership in the newly formed Oncology Work Group. ASH is also continuing to work with policy makers to ensure that future pay-for-performance programs will appropriately address hematology.

PQRI News

CMS Provides Instructions for Accessing PQRI Feedback Reports
CMS has published two articles that give step-by-step instructions for professionals and organizations to access their 2007 PQRI Feedback Reports. The articles for individual professionals and for organizations are available on the CMS Web site.

CMS Announces 2008 PQRI National Provider Call
CMS will host the sixth in a series of national provider conference calls on the 2008 PQRI. This toll-free call will take place from 3:30 p.m. to 5:00 p.m., EDT, on Wednesday, August 13, 2008.

The call will provide an overview of the PQRI provisions in the new Medicare Improvements for Patients and Providers Act (MIPPA) of 2008; information on the E-prescribing measure for 2008 PQRI (measure #125) and proposed measures for 2009 PQRI; incentives for electronic prescribing outlined in the MIPPA; and an update on registry reporting for 2008.

Register online for this call.

Medicare Announces Bonus Payments for PQRI
On July 15, CMS announced payment of more than $36 million in bonus payments to many of the professionals who satisfactorily reported quality information to Medicare under the 2007 PQRI. The average incentive amount for individual professionals was over $600, and the average incentive payment for a physician group practice was over $4,700. For more information about the PQRI program, visit the CMS PQRI Web site.

New Options Available for PQRI 2008 Participation
CMS has announced new options for 2008 PQRI participation.

2008 PQRI National Provider Call PowerPoint Presentation From June 18 Now Available
The PowerPoint presentation that was used during the June 18, 2008, PQRI National Provider Call is now available on the CMS Web site.

2008 PQRI Fact Sheet Now Available
CMS has released a fact sheet that provides an overview of the changes to the 2008 PQRI reporting options, such as alternative reporting periods, alternative criteria for satisfactorily reporting for 2008 measures groups, and registry-based reporting.

PQRI Resources

FAQs

The 2008 PQRI PowerPoint presentation from the December 19, 2007, PQRI National Provider call provides a basic overview of the 2008 Physician Quality Reporting Initiative and the 119 quality reporting measures.

Centers for Medicare and Medicaid Services’ (CMS) 2008 PQRI Tool Kit

PQRI Participation and Coding Tips
CMS has developed a Tip Sheet to assist eligible professionals participating in PQRI with reporting accuracy. This new resource provides helpful tips on the PQRI reporting process and is available on the PQRI Page of the CMS Web site.

Quality Measures for Hematologists
The four hematology-specific measures included in the 2008 PQRI, as well as two health information technology measures that hematologists may find useful.