Clinical Quality Measures: Measuring and monitoring clinical quality measures...Practice Fusion
Learn about:
1. CMS quality measures.
2. How to capture the data in Practice Fusion.
3. How this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
Measuring & Monitoring Clinical Quality Measures Using Practice FusionPractice Fusion
Review CMS quality measures, how to capture the data in Practice Fusion, and how this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
Clinical Quality Measures: Measuring and monitoring clinical quality measures...Practice Fusion
Learn about:
1. CMS quality measures.
2. How to capture the data in Practice Fusion.
3. How this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
Measuring & Monitoring Clinical Quality Measures Using Practice FusionPractice Fusion
Review CMS quality measures, how to capture the data in Practice Fusion, and how this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
Meaningful Use Stage 2 and Health Information Exchange (HIE)MassEHealth
Transformational intent of Meaningful Use (MU) and the increased trend toward interoperability in MU Stage 2 (MU2); MU2 objectives with an HIE component and their MU2 measures; Approaches to achieving the transitions of care; Available public health registries and their current status and submission pathway; How to find a trading partner and best practices to engaging
Transforming Post-Acute Care with IMPACTCitiusTech
On October 6, 2014, a bipartisan bill on Improving Medicare Post-Acute Care Transformation (IMPACT) was signed. The IMPACT Act seeks to standardize assessments for vital care issues across the gamut of post-acute care (PAC) providers and builds a framework to ensure that the delivered care is mindful of the patient needs; thereby eliminating the current silo-focused approach to quality measurement and resource utilization.
Closed Loop Medication Management - A preferred way to go go forward for Prov...CitiusTech
Closed Loop Medication Management (CLMM) system is a fully electronic medication management process that integrates automated and intelligent systems to completely close the inpatient medication management and administration loop, and seamlessly document all the relevant information.
Importance of Medical Audit
Don't let COVID - 19 impact your practice. Get Free Practice Analysis and be financially healthy. Call Now - 888-357-3226
Click Here For More Information: https://bit.ly/3kw4rka
Get a Free Quote: https://bit.ly/30DFr2z
#texasmedicalbillingandcodingservices #medicalbillingauditing #medicare #medicalbillingandcoding #MBC #importanceofmedicalaudit #medicalaudit #medicalbillingguideline
Using Practice Fusion for PQRS EHR Reporting in 2014Practice Fusion
This presentation is an overview of PQRS requirements in 2014, requirements for PQRS EHR reporting, and measure selection and EHR reporting applicability. The presentation will also give a deep dive into using Practice Fusion for PQRS reporting.
Meaningful Use Stage 2 and Health Information Exchange (HIE)MassEHealth
Transformational intent of Meaningful Use (MU) and the increased trend toward interoperability in MU Stage 2 (MU2); MU2 objectives with an HIE component and their MU2 measures; Approaches to achieving the transitions of care; Available public health registries and their current status and submission pathway; How to find a trading partner and best practices to engaging
Transforming Post-Acute Care with IMPACTCitiusTech
On October 6, 2014, a bipartisan bill on Improving Medicare Post-Acute Care Transformation (IMPACT) was signed. The IMPACT Act seeks to standardize assessments for vital care issues across the gamut of post-acute care (PAC) providers and builds a framework to ensure that the delivered care is mindful of the patient needs; thereby eliminating the current silo-focused approach to quality measurement and resource utilization.
Closed Loop Medication Management - A preferred way to go go forward for Prov...CitiusTech
Closed Loop Medication Management (CLMM) system is a fully electronic medication management process that integrates automated and intelligent systems to completely close the inpatient medication management and administration loop, and seamlessly document all the relevant information.
Importance of Medical Audit
Don't let COVID - 19 impact your practice. Get Free Practice Analysis and be financially healthy. Call Now - 888-357-3226
Click Here For More Information: https://bit.ly/3kw4rka
Get a Free Quote: https://bit.ly/30DFr2z
#texasmedicalbillingandcodingservices #medicalbillingauditing #medicare #medicalbillingandcoding #MBC #importanceofmedicalaudit #medicalaudit #medicalbillingguideline
Using Practice Fusion for PQRS EHR Reporting in 2014Practice Fusion
This presentation is an overview of PQRS requirements in 2014, requirements for PQRS EHR reporting, and measure selection and EHR reporting applicability. The presentation will also give a deep dive into using Practice Fusion for PQRS reporting.
Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014Practice Fusion
This webinar, Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014, goes over which reporting options are available, what the incentives and penalties are for participating, reporting requirements, and how to choose quality measure for reporting.
Our Insights webinar this week tackles a little-known program that will have a big impact on fee-for-service Medicare providers. The Value-Based Payment Modifier (or Value Modifier for short) is something every Medicare provider should know about as soon as possible. One way or another, providers will wind up on either the incentive or penalty side of this legislation. Take advantage of our webinar for in-depth information on this complex and far-reaching topic.
2011 CMS Physician Quality Reporting System (PQRS): Teaching Doctors of Chiropractic How to Report on Measures Related to Quality Patient Care by Tony Hamm, American Chiropractic Association
The Guidebook to Medicare Access and CHIP Reauthorization Act of 2015 dispels MACRA myths and puts you in the know with easy-to-follow guidance. Interpret MACRA changes with step-by-step advice to understand and master MACRA’s final rule.
Clinical Quality Measures (CQMs) for Meaningful Use & PQRSEmily Richmond
This presentation provides information on reporting clinical quality measures (CQMs) for Meaningful Use and PQRS, while also providing detailed information on the quality measure specifications that Practice Fusion currently supports.
Practice Fusion is a free, web-based, 2014 certified complete ambulatory EHR.
www.practicefusion.com/signup/
Physician Quality Reporting System (PQRS) is a CMS reporting program that uses a combination of incentive payments and penalties to promote reporting of quality data. This presentation discusses.
PYA Highlights Next Steps of Meaningful UsePYA, P.C.
At the 2013 AICPA Healthcare Industry Conference, PYA Principal David McMillan and Senior Manager Chris Wilson recently explored the “new normal” of meaningful use as compliance and strategic standards in new care/reimbursement-model development.
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This slide deck provides a detailed overview of the PQRS program, including helpful information on how to report for PQRS using the claims-based reporting method. Learn how to report Quality Data Codes for PQRS on Medicare claims and avoid penalties!
PYA Consulting Manager Linda ClenDening helped connect the dots between the data at the 2013 AHIMA Convention and Exhibit in Atlanta. She spoke during the Innovation educational track on the topic: “Beyond Meaningful Use: Connecting Quality Data Requirements to Business Operational Improvements.”
The Medicare and Medicaid EHR Incentive Programs offer financial incentives for the
“meaningful use” of certified EHR technology to improve patient care. Read More.. www.curemd.com
Similar to 2015 Clinical Quality Measures and PQRS Reporting with Practice Fusion (20)
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
2. + Emerging movement in healthcare where
providers are compensated based on:
Quality of the service that they provide to patients
How well they can improve health outcomes
+ Quality of care is evaluated using evidence-based
quality measurement
+ Public and private payers participating in Pay for
Quality initiatives
Pay for Performance (Pay for Quality)
2
3. + Government-run Pay for Performance Initiatives
+ Incentivize or penalize providers to encourage
adoption of health technology and reporting of
Clinical Quality Measures (CQMs)
+ Examples include:
EHR Incentive Program (Meaningful Use)
Physician Quality Reporting System (PQRS)
Accountable Care Organizations (ACOs)
Comprehensive Primary Care initiative (CPCi)
Chronic Care Management (CCM)
Physician Quality Programs
3
4. + Requirement: Report at least 9 CQMs that relate
to at least 3 National Quality Strategy (NQS)
domains:
+ CMS selected 9 recommended CQMs for adult
and pediatric populations
Practice Fusion supports the CMS recommended
CQMs for the adult population
Practice Fusion’s CQMs cover all 6 NQS domains
Meaningful Use CQM Reporting Requirements
Patient and Family Engagement Patient Safety
Care Coordination Population and Public Health
Efficient Use of Healthcare Resources Clinical Processes/Effectiveness
5. CQM Reporting Methods
+ Medicare providers will submit CQMs to CMS electronically or via
attestation
+ Medicaid providers must submit CQM data to their State Medicaid
Agency
+ Reporting period: Entire calendar year or 90 day reporting period
+ Electronic submission for 2015: January 1, 2016 – February 29,
2016
Medicare EPs have the option to submit a full year of data electronically to receive
credit for the EHR Incentive Program and the Physician Quality Reporting System
(PQRS) if using the PQRS EHR reporting mechanism.
6. + The PQRS is a CMS quality improvement
program that uses incentives and penalties to
promote reporting of quality data
+ Eligibility
Providers who see Medicare Part B patients and are
reimbursed under the Medicare Physician Fee
Schedule (PFS)
Physicians, chiropractors, dentists, PAs, NPs, and
others
+ 2015 Incentives and Penalties
No incentive or -2% penalty in 2017
Physician Quality Reporting System (PQRS)
6
7. + PQRS is very complex - PQRS requirements vary based
on the reporting mechanism that you choose.
Complexities mean more options, but you need to become
familiar with the requirements that apply to the option that
you are using.
+ PQRS requirements are specific to each calendar year –
eligible PQRS measures, G-codes, reporting
requirements, etc. may change from year to year, so make
sure you refer to 2015 resources. The 2015 PQRS
reporting period is January 1, 2015-December 31, 2015.
+ PQRS actions don’t roll-over – Reporting for a particular
year will affect your reimbursements in 2 years.
Important PQRS Facts
7
8. + PQRS measures consist of two major components:
Denominator: describes the eligible cases for a measure
(the eligible patient population)
Numerator: describes the clinical action required by the
measure for reporting and performance
+ Each component is defined by specific clinical codes
described in each measure specification along with
reporting instructions.
+ For measures eligible for EHR reporting, Practice Fusion
has implemented the measure according to very specific
guidelines (including how data must be collected and how
the measure is calculated).
Understanding PQRS Measures
8
9. + To avoid the 2017 PQRS
payment adjustment of
2%, you must use one of
the following reporting
options:
Avoiding the 2017 PQRS Payment Penalty
9
Claims-Based Reporting
Registry Reporting
Qualified Clinical Data Registry
(QCDR) Reporting
Group Practice Reporting
Option (GPRO) Reporting
EHR Reporting*EHR Reporting
is the only option
that Practice
Fusion supports
10. + Measures with a zero value denominator cannot be used for PQRS
+ The PQRS measurement period length is a full calendar year, so for
2015 it would run from January 1, 2015 through December 31, 2015.
+ Practice Fusion will act as a Direct EHR Vendor (EHR Direct)
PF will allow providers to generate a file to attest to CMS with as
individuals who choose this reporting option
You can do this from the PQRS Clinical Quality Measures
Dashboard
EHR Reporting for PQRS
10
11. + The following factors should be considered when selecting measures
for reporting:
Clinical conditions usually treated
Types of care typically provided – e.g., preventive, chronic, acute
Settings where care is usually delivered – e.g., office, emergency
department (ED), surgical suite
Quality improvement goals for 2015
Other quality reporting programs in use or being considered
Those available under your selected PQRS reporting option
Those that apply to your Medicare patients
PQRS Measure Selection
11
12. + MAV is a validation process that will determine whether individual
eligible professionals or group practices should have reported
additional measures OR additional domains.
+ MAV determines 2017 PQRS payment adjustment status for individual
providers and group practices.
+ MAV is applied to individual providers and group practices that report
less than nine measures OR less than three domains for PQRS. If
MAV analytically determines that the provider or group practice could
have reported additional measures or domains within the clinical
cluster, then the 2017 PQRS payment adjustment may apply.
+ Claims-based MAV is applicable to individual EPs, whereas registry-
based MAV is applicable to individual EPs and group practices.
Measure-Applicability Validation (MAV)
12
13. + An Enterprise Identity Management (EIDM) account
CMS transitioned all IACS accounts to EIDM in July
2015
An individual in your organization (who does not plan to
submit) or solo providers will first need to register for an
Approver Role
Afterwards, the individuals who plan to submit will need
to register for a PQRS Submitter Role
CMS resources include an EIDM toolkit
+ Individual NPI number
+ Tax Identification Number (TIN)
Information you will need to attest
15. • The population of patients or encounters for which the measure applies.Denominator
• The population of patients from the denominator who meet the measure specified
clinical requirements or the population of encounters from the denominator where
the measure specific requirement has been performed.
Numerator
• Specifications that would remove a patient from the denominator of a specific
quality measure.
• Includes certain diagnoses that make it clinically unnecessary for the patient to
receive the numerator clinical action and/or provider or patient determined reasons
for refusing certain clinical actions.
Exclusion/Exception
• This is also known as the EHR reporting period and refers to the time frame for
which the CQMs will be calculated.
Measurement
Period
CQM Terminology
15
16. • The six NQS domains, one of which is assigned to each CMS eCQM, are:
Patient and Family Engagement, Patient Safety, Care Coordination,
Population and Public Health, Efficient Use of Healthcare Resources, and
Clinical Processes/Effectiveness
National Quality
Strategy (NQS)
Domains
• NQF reviews, endorses, and recommends use of standardized quality
measures. Not all quality measures are “NQF-endorsed,” but those that are
have an assigned NQF number.
National Quality
Forum (NQF)
• Lists of specific values (terms and their codes) derived from single or
multiple standard vocabularies used to define clinical concepts (e.g. patients
with diabetes, clinical visit, reportable diseases) used in clinical quality
measures and to support effective health information exchange.
Value sets
• An HL7-based standard document format for reporting clinical quality
measure data to CMS for quality improvement programs.
Quality Reporting
Document
Architecture (QRDA)
CQM Terminology
16
17. CMS
eMeasureID
NQF
number
CQM title NQS domain
CMS2v4 0418 Preventive Care and Screening:
Screening for Clinical Depression and
Follow-Up Plan
Population and Public
Health
CMS22v3 N/A Screening for High Blood Pressure
and Follow-Up Documented
Population/Public Health
CMS50v3 N/A Closing the referral loop: receipt of
specialist report
Care Coordination
CMS68v4 0419 Documentation of Current
Medications in the Medical Record
Patient Safety
CMS69v3 0421 Preventive Care and Screening: Body
Mass Index (BMI) Screening and
Follow-Up
Population and Public
Health
CMS90v4 N/A Functional Status Assessment for
Complex Chronic Conditions
Patient and Family
Engagement
CMS122v3 0059 Diabetes: Hemoglobin A1c Poor
Control
Clinical Process and
Effectiveness
CMS123v3 0056 Diabetes: Foot Exam Clinical Process and
Effectiveness
Practice Fusion Supported CQMs
17
18. CMS
eMeasureID
NQF
number
CQM title NQS domain
CMS124v3 0032 Cervical Cancer Screening Clinical
Processes/Effectiveness
CMS125v3 0031 Breast Cancer Screening Clinical
Processes/Effectiveness
CMS126v3 0036 Use of Appropriate Medications for
Asthma
Clinical
Processes/Effectiveness
CMS127v3 0043 Pneumonia Vaccination Status for
Older Adults
Clinical
Processes/Effectiveness
CMS130v3 0034 Colorectal Cancer Screening Clinical
Processes/Effectiveness
CMS131v3 0055 Diabetes: Eye Exam Clinical
Processes/Effectiveness
CMS138v3 0028 Preventive Care and Screening:
Tobacco Use: Screening and
Cessation Intervention
Population and Public
Health
CMS139v3 0101 Falls: Screening for Future Fall Risk Patient Safety
Practice Fusion Supported CQMs
18
19. CMS
eMeasureID
NQF
number
CQM title NQS domain
CMS144v3 0083 Heart Failure (HF): Beta-Blocker
Therapy for Left Ventricular Systolic
Dysfunction (LVSD)
Clinical
Processes/Effectiveness
CMS147v3 0041 Preventative Care and Screening:
Influenza Immunization
Population/Public Health
CMS149v3 N/A Dementia: Cognitive Assessment Clinical
Processes/Effectiveness
CMS153v3 0033 Chlamydia Screening for Women Clinical
Processes/Effectiveness
CMS155v3 0024 Weight Assessment and Counseling
for Nutrition and Physical Activity for
Children and Adolescents
Population/Public Health
CMS156v3 0022 Use of High-Risk Medications in the
Elderly
Patient Safety
CMS163v3 0064 Diabetes: Low Density Lipoprotein
(LDL) Management
Clinical
Processes/Effectiveness
CMS164v3 0068 Ischemic Vascular Disease (IVD): Use
of Aspirin or Another Antithrombotic
Clinical
Processes/Effectiveness
Practice Fusion Supported CQMs
19
20. + PQRS Center
www.practicefusion.com/pqrs
Resources for PQRS
20
21. + PQRS Clinical Quality Measures Dashboard
For you to monitor your progress on your Clinical Quality Measures
Click on the measure names to get to a detailed knowledge base article
on the CQM
Allows you to select CQMs you wish to report
Allows you to generate a file to submit to CMS
Resources for CQMs
21
22. + Practice Fusion is not able to offer individual
guidance on choosing PQRS measures or
reporting options that are not EHR reporting.
+ If you have questions regarding individual
measures or how PQRS requirements apply to
you, please reach out to the CMS QualityNet Help
Desk.
CMS QualityNet Help Desk
Phone: 866-288-8912,
TTY: 877-715-6222
Email: qnetsupport@sdps.org
Need Individual Help with PQRS?
22
24. + A: Most health care providers who are reimbursed
under the Medicare Physician Fee Schedule are
eligible for PQRS.
+ For additional details and a list of eligible PQRS
providers go to:
http://www.cms.gov/Medicare/Quality-Initiatives-
Patient-Assessment-
Instruments/PQRS/How_To_Get_Started.html
Q: How do I find out if I’m eligible for PQRS?
24
25. + A: PQRS offers over 300 quality measures, which can be
reported using various reporting mechanisms (although
not all measures are available for all reporting options).
+ If you wish to use Practice Fusion, you only have the
measures we support available to use for PQRS reporting.
You may report less than 9 measures if you meet the other
EHR reporting criteria, but you will be subject to the
Measure Applicability Validation process which means you
may not earn the incentive (although you could avoid the
penalty).
+ If you are a specialty provider who wants to report PQRS
measures that are not available for EHR reporting, we
suggest looking into other reporting mechanisms.
Q: Practice Fusion’s CQMs don’t apply to my
specialty. How will I participate in PQRS?
25
26. + PQRS is a separate and distinct program from
Meaningful Use. Providers who do not report for
PQRS in 2015 will be subject to a 2% payment
penalty – regardless of whether or not they
successfully participate in Meaningful Use.
Q: I’m participating in Meaningful Use this year,
will there be penalties if I don’t also participate in
PQRS?
26
27. + A: The EHR reporting option for PQRS require
that providers report CQM data for all patients,
regardless of their insurance status. Providers will
report data for all patients whom the CQM applies
that have data in the EHR.
Q: Does PQRS EHR Reporting only apply to
Medicare patients?
27
28. + A: Please reach out to the CMS QualityNet Help
Desk.
CMS QualityNet Help Desk
Phone: 866-288-8912,
TTY: 877-715-6222
Email: qnetsupport@sdps.org
Q: How do we check if we have completed
PQRS successfully with Medicare?
28
29. + A: Unfortunately not. Your participation in 2014
determined your penalty in 2016. To avoid a 2017
penalty, be sure to report successfully for the
2015 reporting period.
Q: I received notification from Medicare that I
will be penalized in 2016. Is there anything I can
do now to avoid this?
29
30. + We have recorded this session, and will make the
slide deck and recording available on our Tutorials
Center
Q: Will a recording of the webinar be made
available?
30
Editor's Notes
WHAT ARE CLINICAL QUALITY MEASURES?
Clinical quality measures, also called CQMs, are tools that help us measure and monitor the quality of healthcare and the contribution of those healthcare services towards improved health outcomes. In the past, quality measures primarily used data that came from claims, but as technology has improved and become more prominent in the healthcare setting, many quality measures now use data that comes from a provider’s electronic health record (EHR). These electronic CQMs (eCQMs) use EHR data to measure health outcomes, clinical processes, patient safety, efficient use of healthcare resources, care coordination, patient engagement, and population and public health improvement.
The MAV Clinical Relation/Domain Test is based on:
(1) If an individual eligible professional (EP) or group practice reports data for a measure, then that measure applies to their practice, and(2) The concept that if one measure in a cluster of measures related to a particular clinical topic, OR individual EP, or group practice service is applicable to an individual EP’s or group’s practice, then other closely-related measures (measures in that same cluster) would also be applicable.
The MAV Clinical Relation/Domain Test is based on:
(1) If an individual eligible professional (EP) or group practice reports data for a measure, then that measure applies to their practice, and(2) The concept that if one measure in a cluster of measures related to a particular clinical topic, OR individual EP, or group practice service is applicable to an individual EP’s or group’s practice, then other closely-related measures (measures in that same cluster) would also be applicable.