In 2008, the only Physician Quality Reporting Initiative (PQRI) measure that applied to rheumatoid arthritis (RA) was disease-modifying antirheumatic drug therapy. For 2009, five new RA measures were included, for a total of six measures in the new RA Measures Group. The five new measures were developed in 2008 by the National Committee for Quality Assurance in collaboration with the ACR and the American Medical Association’s Physician Consortium for Performance Improvement and were subsequently adopted by Medicare.
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Explore This IssueMay 2009
The new measures are tuberculosis screening prior to beginning anti–tumor necrosis factor therapy, periodic assessment of disease activity, functional status assessment, assessment and classification of disease prognosis, and glucocorticoid management. Other measures on which rheumatologists can report include osteoporosis, osteoarthritis, assessment of pain, back pain, falls, and health information technology. With the exception of back pain, these measures can be reported individually or as part of a measures group.
Why Use the RCR Instead of Claims-Based Reporting?
Using the RCR for PQRI reporting provides several advantages over claims-based reporting:
- Users can collect clinical information at a pace that suits their clinical workflow.
- Users can print forms to incorporate into the paper record until Web-based data entry can be done.
- Information can be collected by a downloadable Excel spreadsheet that can be subsequently uploaded to the RCR.
- Because registry reporting does not need to occur at the same time as submitting claims for patient visits, users will have the option to employ batch reporting for 2009 PQRI as late as February 2010.
- There is no need to report any CPT II codes.
- Office managers or other designated personnel can complete the forms for the providers, who can then review and sign the forms for submission.
- The RCR is being developed to integrate with major electronic medical records.
- Outcome Sciences, the RCR development company, is a registered vendor with the Centers for Medicare and Medicaid Services. This makes reporting for PQRI using the RCR an easy, streamlined process that will have fewer errors and be more likely to be reimbursed fully than claims-based reporting would.
PQRI is voluntary and involves payment for participation in the program. Currently, the incentive to participate is a two-percent bonus on all allowable 2009 Medicare Part B fee-for-service charges during the reporting period, with no cap. It is anticipated that in future years this incentive may increase substantially or that penalties for nonparticipation may be implemented, so rheumatologists and other eligible health professionals are encouraged to get in the habit of reporting now.