Regardless of all the uncertainty in the current healthcare environment, one thing is clear: demonstrating quality patient care by adhering to guidelines and best practices and using data to monitor and improve gaps in patient care and outcomes will continue to increase in significance. Quality improvement initiatives have received bipartisan support and have been pervasive in both Republican and Democratic administrations. Irrespective of whether the Supreme Court determines parts of the Affordable Care Act (ACA) to be unconstitutional, the ideas built into the current quality programs were prevalent long before the ACA and have already gained considerable momentum and will only increase in importance.
ACR’s Registry Efforts
For the past several years, the ACR has been working to help the rheumatology provider community become better prepared to demonstrate the high-quality care our members deliver to patients with rheumatic disease. One of the most valuable tools the ACR has developed to help members implement quality initiatives and meet national quality reporting program requirements is the Rheumatology Clinical Registry (RCR).
The RCR is a free, easy-to-use tool developed to assist members in practice improvement, local population management, and efficient, successful participation in national quality programs. The RCR integrates evidence-based quality measures aimed at improving care and drug safety for patients with rheumatoid arthritis, osteoarthritis, osteoporosis, gout, and juvenile idiopathic arthritis.
To date, more than 600 members have entered data on more than 18,000 patients into the RCR. The ACR has established the RCR as a highly successful means of reporting data to the Centers for Medicare and Medicaid Services (CMS) Physician Quality Reporting System (PQRS) program, and both PQRS and CMS e-Prescribing reporting are available using the RCR in 2012. Approximately 90% of rheumatologists who use the RCR for PQRS reporting in 2009 received their incentive payments, which is well above the approximately 60% average across all specialties and PQRS reporting mechanisms. A new feature of the RCR is the ability for the clinician to generate a report that will assess whether quality-reporting requirements are met and allow RCR users to make changes to ensure a successful submission. This feature should further increase successful PQRS reporting.
The RCR is also an excellent tool for completing quality-improvement modules for maintenance of certification. There are 48 rheumatoid arthritis measures incorporated into the RCR that can be used for American Board of Internal Medicine performance improvement requirements. The ACR also recently integrated its Assess Improve Measure (AIM) program into the RCR, so users can more seamlessly use the RCR for maintenance of certification and to perform quality-improvement projects in their practice.