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Physician Quality Reporting Initiative (PQRI) Changes for 2008

  |  Issue: June 2008  |  

CMS has announced alternative reporting periods and reporting criteria for the 2008 Physician Quality Reporting Initiative (PQRI).

PQRI provides bonus payments to practitioners who satisfactorily report on CMS-approved measures on a variety of topics, such as RA, osteoporosis, osteoarthritis, and pain management.

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There are now nine possible reporting options—including claims- and registry-based reporting of individual measures and measure groups—for six- or 12-month reporting periods ending December 31, 2008. Three of the nine possible reporting options apply to rheumatology practitioners (the other six use measure groups that include non-rheumatology measures):

  1. Report through claims for January 1–December 31, 2008
  2. Report through registry for January 1–December 31, 2008
  3. Report through registry for July 1–December 31, 2008

The second and third options are contingent on the registry being on the CMS-approved registry list that will be posted on the CMS Web site by August 31, 2008.

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There is no half-year claims-based individual measure reporting option. The half-year reporting possibility only applies if providers use a registry or if they report the largely non–rheumatology focused measure groups through claims. However, practitioners who did not begin claims-based reporting in early 2008 may still be able to successfully participate in full-year individual measure claims-based reporting by using measures that require reporting only once per year. Examples include measures #4 (screening for falls risk), #39 (osteoporosis screening), #41 (osteoporosis: pharmacologic therapy), and #108 (RA DMARD use).

Measures that must be reported after each visit should not be started mid-year because practitioners would likely not meet the minimum annual reporting requirements. Examples include measures #24 (osteoporosis: post fracture communication), #40 (osteoporosis: management following fracture), #109 (osteoarthritis functional assessment), #124 (electronic health records), and #125 (e-prescribing).

More information on PQRI and these recent changes is available at www.cms.gov/pqri.

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