Net Health Specialty Care Registry
Quality is important to us at Net Health so we make clear paths for you to comply with various CMS quality initiatives. The Net Health Specialty Care Registry for PQRS reporting (an official CMS registry) is our commitment to giving you the tools needed to simply and effectively comply with this important program that impacts your clinic’s bottom line.
What’s PQRS? The Physician Quality Reporting System (PQRS) is a CMS program aimed at gathering information to help Eligible Professionals (EPs) measure the quality of care provided to Medicare beneficiaries. Launched in 2006, the program encourages voluntary reporting of data measures that CMS believes help determine quality of care in the Medicare Part B population.
Six things to know about PQRS and our Registry:
- The cost is $299, per provider (annually).
- Registration is open! Sign up for the Registry here.
- EPs should participate. Beginning in 2015, the program applied a negative adjustment to individual EPs and PQRS group practices who did not satisfactorily report data on quality measures for Medicare Part B Physician Fee Schedule (MPFS). By reporting in 2016, EPs will avoid negative payment adjustments in 2018. Are you an EP? Find out below.
- For the 2016 reporting year, our Registry will support both upload functionality and EHR users.
- Within the Net Health Specialty Care Registry, we support 10 individual measures that are most relevant to your workflow.
- Contact us via the 2016 info form if you have questions about the registration process.
If you are an Agility client, use the Net Health Specialty Care Registry because:
It’s easy – registration is a simple online process for Eligible Professionals (EPs).
It’s expedient – Your data will be seamlessly exported to CMS. Data formatting questions and due date reminders are gone. We have you covered—automatically.
Register here with the Net Health Specialty Care Registry.
What is PQRS and why is it important?
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PQRS is a quality reporting program that encourages individual EPs and group practices to report information on the quality of care to Medicare.
It’s important and relevant to you.
According to CMS, “PQRS gives participating EPs the opportunity to assess the quality of care they are providing to their patients, helping to ensure that patients get the right care at the right time. By reporting PQRS quality measures, providers also can quantify how often they are meeting a particular quality metric. Using the feedback report provided by CMS, EPs can compare their performance on a given measure with their peers.”
2016 is an important year.
Over the life of the program CMS has rewarded successful participation (more money for Medicare Part B service providers). In 2016 like 2015, if an individual EP or group practice does not satisfactorily report or satisfactorily participate while submitting data on PQRS quality measures, a 2% payment adjustment will apply in 2018
Who is an “Eligible Professional” (EP) for PQRS?
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Here’s the list of professionals eligible to participate in PQRS. Read this list carefully, not all entities are considered “eligible professionals” because some are reimbursed by Medicare under other fee schedule methods than the Physician Fee Schedule (PFS).
- Doctor of Medicine
- Doctor of Osteopathy
- Doctor of Podiatric Medicine
- Doctor of Optometry
- Doctor of Oral Surgery
- Doctor of Dental Medicine
- Doctor of Chiropractic
- Physician Assistant
- Nurse Practitioner*
- Clinical Nurse Specialist*
- Certified Registered Nurse Anesthetist* (and Anesthesiologist Assistant)
- Certified Nurse Midwife*
- Clinical Social Worker
- Clinical Psychologist
- Registered Dietician
- Nutrition Professional
*Includes Advanced Practice Registered Nurse (APRN)
- Physical Therapist
- Occupational Therapist
- Qualified Speech-Language Therapist
Note: Professionals who reassign benefits to a Critical Access Hospital (CAH) that bills professional services at a facility level, such as CAH Method II billing, can participate via all reporting mechanisms. To do so, the CAH must include the individual provider NPI on their Institutional (FI) claims.
Read more about PQRS EPs via CMS here.
Does an Eligible Professional (EP) have to pre-register with CMS to participate in PQRS (like you do with the Meaningful Use program)?
Find out »
Yes, an EP must sign up through their EIDM account (formerly known as IACS).
Note from CMS:
The Centers for Medicare & Medicaid Services (CMS) retired the Individuals Authorized Access to CMS Computer Services (IACS) system on July 13, 2015. Active IACS user accounts were transitioned to a CMS system called Enterprise Identity Management (EIDM). The EIDM system provides a way for business partners to apply for, obtain approval of, and receive a single user ID for accessing multiple CMS applications.
This document provides helpful resources for former Physician Quality Reporting System (PQRS) IACS users now utilizing the EIDM system:
How can an Eligible Professional (EP) participate in the 2016 PQRS process?
Find out »
Register here for PQRS data submission using the Net Health Specialty Care Registry. We’ve done the leg work to ensure that the Registry supports the latest measures that are most appropriate for you. Your EHR is already hard at work; it’s just an additional step to use it to collect PQRS data and export it directly to CMS.
Read more about the available PQRS reporting measures and assess which are the most applicable to the Medicare Part B population you see.
Complete this form if you have any questions about the PQRS registration process or 2016/2017 reporting obligations.
What is the benefit of PQRS reporting?
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There are significant financial and clinical benefits.
- Avoid a 2% penalty (deduction) in your 2018 payments for Medicare Part B PFS covered professional services.
- Assess and quantify your own progress toward meeting quality standards Medicare Part B beneficiary care.
Continue reading this FAQ for other important details of the PQRS program. The Net Health Specialty Care Registry supports your goals to satisfactorily report to CMS with automatic reporting from your EHR.
How can an Eligible Professional (EP) avoid the 2018 PQRS payment adjustment?
Find out »
Participate in 2016 reporting. Let the Registry help you succeed.
- Learn which measures are available.
- Learn more about the Net Health Specialty Care Registry reporting process.
- Register here.
- Upload your full 2016 year files to the Registry no later than February 17, 2017
Which measures does Net Health Specialty Care Registry support?
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Download a list of measures our registry supports below. This document also provides full CMS documentation for each measure.
For the 2016 reporting period, the Net Health Specialty Care Registry supports 10 measures. Each measure is associated with an NQS Domain (National Quality Strategy Domain), as you’ll see in the table below.
Of the measures reported, if the EP sees 1 Medicare patient in a face to face encounter, you must report on at least 1 cross cutting measure (included in the 9 measures) in order to avoid the 2018 payment adjustment. To find out more about the cross cutting measures click here.
Notice that each measure (or measure group) has a reporting frequency or timeframe requirement for each eligible patient seen during the reporting period by each individual EP. The reporting frequency is found in the instructions section of each measure, which you can access here. Frequency is a key area where workflow comes into play. Ensure that all members of the team understand the reporting frequency and capture this information in the patients’ medical record to facilitate optimal data capture.
Measure selection is an important task. Once you register with the Net Health Specialty Care Registry, you’ll visit Net Health University (click here if you don’t already have an account) for further information including data entry requirements to be required in your workflow for each measure. You’ll find the PQRS folder within the Agility Release Content course.
I’m ready! How do I get started?
Find out »
Let’s do a fast check. Did you:
- Determine if you are an Eligible Professional (EP)? See list of eligible professionals.
- Determine the volume of Medicare Part B PFS covered professional services you do at your practice setting, and consider the 2% penalty if you do not satisfactorily report 2016 information?
- Determine if the financial impact in 2018 (a 2% deduction on the payment from Medicare Part B PFS covered professional services) is something you want to avoid. This penalty will be a reality if you choose not to report this year.
Great! You sound ready.
STEP 1 – Register
Contact us if you have any questions about the PQRS registration process or 2016/2017 reporting obligations.
STEP 2 – Document
When you register, you’ll be asked to select the measures on which you will report. To avoid the 2% penalty on your 2016 Medicare Part B PFS covered services, EPs must choose to report least 9 measures across 3 NQS domains. Of the measures reported, if the EP sees 1 Medicare patient in a face to face encounter, you must report on at least 1 cross cutting measure (included in the 9 measures) in order to avoid the 2018 payment adjustment.
If you’ve just made the decision to submit 2016 PQRS data, be careful to select measures that your providers have already been entering data for in 2016.
STEP 3 – Review
Begin assessing your own progress toward the measures you plan to report by using the PQRS XML Data Extract Utility in Agility (accessible from the Quality Measure Reporting selection). The generated report will indicate if a patient or a visit falls into the category of meeting a measure and the necessary detail report to validate the numbers.
After the reporting year ends on 12/31/2016, you’ll want to check your PQRS Reports one last time.
Review the data collected from your chosen measures. Run the final extract of the reports for each Eligible Provider for the 2016 reports.
STEP 4 – Report
Sign into the Net Health Specialty Care Registry and upload the XML file that was generated with the Agility report. The registry will automatically submit your data to CMS on your behalf. Once the file is uploaded, there are no additional steps you need to take. You will be notified via email from the Registry confirming that your file was received successfully.