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PQRS Report for 2014

On April 15, 2016, CMS released the 2014 Reporting Experience for the PQRS program.  This report shows trends from 2007-2014 including the number of participants, incentive bonus payments, methods of reporting and other statistics.  Of note, 2014 was the last year that yielded a bonus for those meeting the incentive criteria. 

As a specialty, ophthalmology is referenced in several areas.

  • One of six specialties receiving incentive payments of $1,000 or more.
  • Tenth highest specialty reporting through a registry.
  • Sixth highest specialty using EHR reporting
  • A significantly higher percentage of eligible professionals who qualified for an incentive when using EHR reporting.
  • The number of ophthalmic eligible professionals subject to a payment adjustment in 2016 is 34%.  This is an increase from 2015, when it was 27%.

The five most frequent measures reported in ophthalmology in 2014 were:

  • 12 — Primary Open Angle Glaucoma (POAG):  Optic Nerve Evaluation
  • 117 — Diabetes:  Eye Exam
  • 14 — Age-related Macular Degeneration (AMD):  Dilated Macular Examination
  • 18 — Diabetic Retinopathy:  Documentation Of Presence or Absence Of Macular Edema And Level Of Severity Of Retinopathy
  • 130 — Documentation of Current Medications in the Medical Record

The report concludes by indicating a 30% participation increase in PQRS in 2014 with approximately two-thirds of eligible professionals participating in some capacity.  For those group practices with ten or more eligible professionals, success with PQRS in 2014 was especially important because of the introduction of the Value Based Payment Modifier that includes the PQRS program as a component. 

The complete report can be accessed at:  https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/pqrs/analysisandpayment.html

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