The Physician Quality Reporting System (PQRS) uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals. Examples of eligible professionals include physicians, physicians assistants, nurse practitioners, physical therapists, occupational therapists and clinical psychologists. The ACR is actively communicating with its membership on requirements, methodologies and documentation. The ACR is actively engaged in developing a registry that will aid the membership in meeting the requirements of PQRS. Our members have been reporting these measures through the initial iteration of our registry (RCR). We are seeking participation in our new RISE (Registry Informatics Supporting Effectiveness) registry as a substitute for individual quality measure reporting.
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Explore This IssueJune 2014
The current fee-for-service system of healthcare payment and reimbursement is projected to be phased out and replaced by different models. The Accountable Care Organization (ACO) is one well-publicized model created by the ACA. The definition of ACOs varies widely, but is an organization that is held accountable for the health of a defined population. To date, relatively few ACOs have been created, and participation by physicians remains relatively low.
Healthcare reform has placed much emphasis on population health and population health management. Data, registries, ACOs and patient-centered medical homes are means to potentially provide a better understanding of the nation’s public health or population health and produce improved health outcomes. What does the data say? Who is responsible? Who is accountable? What are the outcomes? These are questions that have not previously been answered.
Where is the patient in the equation? The ACA uses patient centeredness, patient satisfaction, shared decision-making and patient engagement to reinforce one of the Institute of Medicine’s goals for a 21st century healthcare system. A recent report by Millenson and Macri for the Robert Wood Johnson Foundation describe this as an “unsung transformation.” The ACR is studying means to incorporate patients into quality measure development, classification criteria and treatment guidelines in line with modern practice. We also seek ways to effectively and efficiently collect patient-derived data so our practices can know and report this important information.
Advocacy is a core strength of ACR and its members. The Government Affairs Committee, our passionate volunteers and arthritis advocates have led the way on the issue of the Sustainable Growth Rate and also on efforts to make treatments more accessible to patients. The Simple Tasks campaign bridges our patients’ needs with the value of rheumatology professionals to satisfy those needs. Communicating the value of rheumatology to external stakeholders and decision-makers is critical to our specialty’s future. Indeed, the vision of the ACR is that everyone will know the value and role of rheumatology.