The U.S. Department of Health and Human Services (HHS) has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.
HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.
- New England Journal of Medicine article by Secretary Burwell
- Why this matters
- Fact sheet: Goals and Learning and Action Network
- More about Better Care, Smarter Spending, and Healthier People
PQRS: Physician Quality Reporting System
PQRS (formerly known as the Physician Quality Reporting Initiative, or PQRI) is a reporting program that uses a combination of incentive payments and negative payment adjustments to promote reporting of quality information by eligible professionals (EPs).
The program provides an incentive payment to practices with EPs (identified on claims by their individual National Provider Identifier [NPI] and Tax Identification Number [TIN]). EPs satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer).
More information available at the PQRS website.
- WEBINAR: MIPS Data Submission: Practical Advice for Small Group Practices and Solo Practitioners
- WEBINAR: Medicare Physician Payment Changes in 2019:An Introduction to the AMA Payment Model Evaluator
- CMS extends deadline for 2016 PQRS EHR submission
- Subscribers of the PQRS listserv are encouraged to sign up for the new CMS Quality Payment Program listserv
- Deadline for informal review of potential PQRS penalties extended to Dec. 7, 2016
- Submit an Informal Review for 2017 Physician Quality Reporting System Results through November 30, 2016
- PQRS Corner: Two Medicare quality webinars: Understanding your AQRUR (Oct. 31 and Nov. 1); MACRA 101 (Nov. 16 and 22)
- PQRS Corner: News you can use, including a 2016 Implementation Guide QRUR report info
- PQRS Corner: Key reporting deadlines, including 2/15 2015 PQRS data; Med minute podcasts; and upcoming diabetes self-management workshops
- PQRS Corner: Avoid an automatic -2.0 percent PQRS payment adjustment to your Medicare Part B payments. 2015 PQRS data submission deadlines enclosed.
- CMS Announces Submission Timeframes for 2015 PQRS Data
- PQRS “What you Need to Know for 2016” live webinars: Tuesday, January 12 at 12:15 p.m. or Thursday, January 21 at 4 p.m.
- PQRS Corner: 2014 AQRUR informal review deadline extended to Dec 16 | PQRS Reporting year ending soon | PQRS Changes in 2016 physician fee schedule final rule
- PQRS Corner: Informal review deadline extended and AQRUR encore webinar
- Heads up: what physicians need to know with the end of 2015 in sight
- Free on-demand PQRS webinars available
- CMS informal review of 2016 Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) deadline extended to Nov. 23
- PQRS Corner: What physicians need to know about PQRS as 2015 comes to an end
- PQRS Corner: Upcoming webinars and deadlines
- October issue of the QIO News newsletter
- Five Key Ways to Optimize EHRs for Better Patient Health
- By the Numbers: QIN-QIOs Surpass Recruitment Goals for Quality Improvement Initiatives
- PQRS Corner: Informal Review Deadline, Webinars, Physician Compare
- PQRS 2016 Informal Review Process: Requests must be submitted by Nov. 9th
- Registration now open: Medicare Quality Reporting Programs, Sept. 24th 2017 Payment Adjustments Call
- Preview: September 17th 2014 Annual Quality and Resource Use Reports call
- Two upcoming webinars: Understanding the Value-Based Payment Modifier (VM); and Decoding the Annual Quality and Resource Use Report (AQRUR)
- Reminder: Provider Enrollment, Chain, and Ownership System (PECOS)
- Overview: Medicare webinar page
- PQRS Corner: GPRO registration deadline; PQRS webinar; QualityNet Help Desk (June 19)
- Meaningful Use Hardship Exception (June 19)
- Connecticut State Medical Society to host PQRS lunchtime webinars on June 17 and 25
- 2015 eCQMs Annual Updates Now Available (June 1)
- Have an Idea For PQRS Measures? (May 26)
- PQRS Corner - eCQMs, 2015 Program Testing Tool, QualityNet Help Desk (May 18)
- Groups: Go GPRO by June 30, 2015 (May 18)
- Mid-Year Quality and Resource Use Reports (May 1)
- Group Practice Reporting Option for 2015 (April 20)
- Quality and Resource Use Reports (QRUR) (April 10, 2015)
- Medicare Learning Network Resources for PQRS - interactive guide (April 2, 2015)
- Additional PQRS/Value Modifier Webinar Scheduled (March 30, 2015)
- Webinars scheduled for March 18th and 23rd (March 10, 2015)
- One pager: Incorrect EP program name? (Feb. 27, 2015)
- Deadline to file 2014 PQRS data extended to March 20th (Feb. 20, 2015)