The 2009 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, 2008, to December 31, 2008, may earn a bonus payment, subject to a cap, of 2.0 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 ASH Executive Committee, the ASH 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, the measures addressing electronic health records 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
PQRI National Provider Call With Q&A - Wednesday, June 17, 2:30 p.m. - 4:30 p.m., EDT
The CMS Provider Communications Group hosted a national provider conference call on the 2009 PQRI. This toll-free call took place from 2:30 p.m. - 4:30 p.m., EDT, on Wednesday, June 17, 2009. The call covered:
- How to access the PQRI help desk;
- Review of the incentive payments and feedback reports timeline; and
- An update on the upcoming decisions registries for 2009.
Slide Presentation - PQRI and E-Prescribing: Nuts and Bolts
General
CMS Document - PQRI & E-Prescribing: Implementation Advice for the Office Manager
Center for Medicare and Medicaid Services' (CMS) PQRI Web Site
The CMS Web site's PQRI section has numerous useful links and documents.
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.
Centers for Medicare and Medicaid Services' (CMS) 2009 PQRI Tool Kit
ASH Hematology Quality Metrics
Intended Audience and Patient Population:
Any hematologist caring for patients age 18 years and older with myelodysplastic syndrome, acute leukemias, multiple myeloma, or chronic lymphocytic leukemia.
These clinical performance measures are designed for individual quality improvement. Some of the measures may also be appropriate for accountability if appropriate sample sizes and implementation rules are achieved.
- Overview of Measure Development Process
- Myelodysplastic Syndrome and Acute Leukemias
CMS Measure #67 (Hematology Measure #1) - Baseline cytogenetic testing performed on bone marrow - Myelodysplastic Syndrome
CMS Measure #68 (Hematology Measure #2) - Documentation of baseline iron stores in patients receiving erythropoietin therapy - Multiple Myeloma
CMS Meaure #69 (Hematology Measure #3) - Treatment with bisphosphonates - Chronic Lymphocytic Leukemia
CMS Measure #70 (Hematology Measure #4) - Baseline flow cytometry
The following Health Information Technology Measure may also be of use to hematologists:
- Adoption/Use of Health Information Technology
CMS Measure #124 - Electronic health records