"Better late than never" is not just a phrase, it’s a way of life for those finding out about quality metric reporting at the 11th hour. Doctors and medical providers in general are well-known for our procrastination. We can perform in a pinch and, hell, we are trained to react in emergencies, not plan for them—save for our training. However, in many aspects of our day-to-day life, being late is not okay. Attend a Broadway show, a MLB or even an NBA game and we are asked to wait for a break in the action to be seated—if we are even allowed to be seated at the opera or ballet if tardiness occurs. Not to fear. In the world quality metric reporting, particularly for Medicare’s Quality Clinical Data Registry (QCDR) or Physician’s Quality Reporting System (PQRS), better late than never still prevails... for now.
How so, you may ask? Read on.
Despite all the hub bub about Pay for Performance, we are still primarily in a Pay for Reporting world relative to PQRS and the emerging QCDR world. By 2018 PQRS will be dead as the Merit-based Incentive Payment System (MIPS) commences and only the QCDR program and perhaps your EMR’s 64 options (from a slew of 400+ quality metrics currently available) will be your only options. It’s not the EMR’s fault, but they are only allowed to report on 64 measures meaning they CANNOT report on most of the measures doctors/providers may need. Furthermore, the QCDR organizations wrote their own quality measures that replace the need for PQRS participation or, until 2018, can be used in combination with the PQRS quality metrics. This means very specific measures with your practice parameters may be uniquely available with the right QCDR. Even better is that if you work with the right QCDR, they may even be willing to help author metrics to submit for Medicare validation for the next reporting year!
Better late than never simply means that if you report in the 3rd or 4th quarter of the reporting year, and you and your practice(s) have to retroactively collect data, all is not lost. You do not have to well to avoid penalty, you just have to have reported. If you are one of many specialties for which the 400+ PQRS metrics do not adequately speak to the care you provide (and no, you are not alone in that realization), QCDRs may be your best bet. However, many providers were fearful that reporting on 50% of your patients is impossible after the 2nd quarter of the reporting year. It’s admittedly challenging, but it may not matter. The quality or success of your metrics compared to your peers won’t matter until 2018. In fact, how well you report matters not in 2016 and 2017; rather it’s simply whether you reported or not. With this in mind, simply report your patient measures with a retrospective chart review and submit this data to your QCDR or PQRS registry. Nothing more, nothing less. Obviously the goal is to identify potentially problematic clinical areas that could use some tweaking clinically and subsequently improve clinical outcomes, save money and improve public health or patient safety. These are the goal of the reporting program: to detect and correct practices that can affect the health and well-being of our patients and have positive fiscal impact on the system at large.
With this in mind, whether it’s July 5th or November 20th (and yes, January and February can work here, too) simply sign up, research your data relative to the metrics on which you are reporting and as long as you don’t get a zero and do report on >50% of your patients, QCDR participation will remain a viable option to do your quality reporting and avoid a penal adjustment to your federal practice income.