An Easy Way to Participate in Medicare’s New Pay-for-Performance Program
Wouldn’t it be nice if your practice management system automatically incorporated emerging reporting and performance initiatives so you didn’t have to spend valuable staff time figuring out the new rules?
athenahealth is happy to announce that its web-based athenaCollectorSM practice management system now includes new physician quality measures and coding rules for its entire national client base.
The Centers for Medicare and Medicaid Services (CMS) recently established the Physician Quality Reporting Initiative (PQRI). Providers who successfully report quality measure data on claims for services between July 1 and December 31, 2007 will be eligible for a single consolidated incentive payment in mid 2008. The bonus payment is the equivalent of 1.5 percent of total allowed charges for covered physician fee schedule services provided from July 1 through December 31, 2007.
athenahealth has built proactive “Medicare PQRI Rules” that are independent of each other, allowing medical practices to select the measures that are appropriate for the providers at their practice.
“We make it easy for clients to continue using athenaCollector the way they’re used to while taking advantage of this program,” said Lisa Melanson, a rules associate who has been working on this initiative at athenahealth [see her profile in this issue]. “The new rules are automatically incorporated into athenaCollector. Once clients select which rules apply to their practice, they don’t need to do anything differently. Of course, our Account Managers have all the information they need to be helpful to clients who have questions or need support.”
PQRI is part of CMS’ overall quality improvement effort. Participating physicians benefit from capturing data about the quality of care provided to Medicare beneficiaries along a set of 74 distinct measures. These quality measures are typically based on a combination of diagnosis and procedure codes, but may also include other factors such as the patient’s age.
“We’ve been studying this initiative for a long time,” said Kim Williams, athenahealth’s rules and format manager. “Our PQRI team members are now experts on the new measures, which are changing sometimes weekly.” The team stays on top of continually changing information by monitoring the CMS website, reading bulletins, and participating in provider conference calls.
As the PQRI program is subject to updates and modifications by CMS, athenahealth’s flexible, web-based system will update various changes in the program as they happen to allow physicians to continue maximizing their reimbursement.
Visit the CMS website for detailed specifications and additional information.