Physician Quality Reporting System
The PQRS program encourages eligible professionals to report quality measures intended to improve care and show opportunities for improvement. Participation in the program, which informs value-based modifier calculations, is required to avoid payment reductions.
Avoiding Penalties
Requirements to avoid the 2018 payment adjustment (-2.0% for all eligible professionals) based on 2016 reporting are the same as those for the 2015 incentive, with several additional requirements.
Individual EPs and physician group practices can avoid penalties by doing any one of the following:
- Successfully report on nine individual measures across three National Quality Strategy domains for at least 50% of your eligible patients
- One of the nine measures must be a cross-cutting measure, if you have face-to-face encounters
- If you are unable to report nine measures, follow the Measures Applicability Validation Process
- Successfully report on one measure group for at least 20 eligible patients, more than 50% of whom must be Medicare beneficiaries
- Successfully participate in a Qualified Clinical Data Registry or a traditional registry