QRUR: The moment we have been waiting for
After the earth completes another rotation, with your IACS credentials firmly in hand, you will have the opportunity to log into the CMS Portal. When you are in, look for the yellow drop-down menu in the upper-left corner and select “QRUR-Reports.” On the next page, select the year you are looking for (2013) and the report you would like.
QRUR and FLAs
Many of you are already familiar with IACS and PTAN, but let me assure you, QRUR is a four-letter acronym (FLA) that is well worth your attention. CMS is planning to provide greater clarity during an upcoming MLN Connects call.
When are QRURs no longer available?
Therefore, the Quality and Resource Use Reports (QRURs) are no longer available after December 31, 2018.
What are the benchmarks for QRURs?
The quality benchmarks shown in this document are the means and standard deviations for each measure that were included in the Performance Calendar Year 2016 Annual QRURs and used in the calculation of the 2018 Value Modifier. The benchmarks for each quality measure are based on the performance of all solo practitioners and groups nationwide in 2015, the year prior to the performance year (2015 benchmarks for the 2016 performance year). A group or solo practitioner's individual measure score that was part of the overall quality composite for the Value Modifier depended on the group or solo practitioner’s performance rate relative to the benchmark for that measure. Groups and solo practitioners can use this document to review the benchmarks and see how their performance on each of the quality measures compared to the mean for all solo practices and groups nationwide.
What is the CMS value modifier?
CMS applies an upward or neutral Value Modifier payment adjustment to 2018 Medicare Physician Fee Schedule payments to physicians, PAs, NPs, CNSs, and CRNAs based on the performance of their practice on quality and cost measures during the 2016 performance period. CMS announced results of the 2018 Value Modifier and the adjustment factor that was applied to groups and solo practitioners that received an upward payment adjustment in 2018. The payment adjustment factor in 2018 was +6.6%.
What is CMS public use file?
CMS released a de-identified Public Use File, which contains data about practices subject to the 2018 Value Modifier. The information provides the 2018 Value Modifier quality and cost tiers along with the payment adjustments for each practice based on their performance in 2016.
What is MIPS in Medicare?
The Merit-based Incentive Payment System (MIPS) under the Quality Payment Program has replaced the Value Modifier program. The Centers for Medicare & Medicaid Services (CMS) encourages everyone to learn more about the Quality Payment Program by visiting https://qpp.cms.gov/. Please note that the QRURs are not the same as the MIPS Performance Feedback available under the Quality Payment Program.
How to contact the Quality Payment Program Service Center?
For questions about the Value Modifier or the Quality Payment Program, contact the Quality Payment Program Service Center by phone at 1-866-288-8292 or by email at [email protected]. The Service Center is available Monday – Friday; 8:00 A.M. – 8:00 P.M. Eastern Time Zone.
Can a practice request an informal review of its 2018 value modifier payment adjustment?
The informal review request for the 2018 Value Modifier has closed; therefore, a practice can no longer request an informal review of its 2018 Value Modifier payment adjustment.
Why is QRUR important for Medicare?
As Medicare shifts from a system that rewards volume of service to one that rewards quality and efficiency , physicians will need to prepare themselves for success. The QRUR can serve as a resource to navigate this transition because it pinpoints where a practice is doing well and where it needs improvement.
Can VBPM be used for Medicare?
Under the VBPM, solo physicians or groups whose quality and cost scores are high could be eligible for a bonus to their Medicare reimbursement. On the other hand, solo physicians or groups whose quality and cost scores are low could face penalties that decrease their Medicare reimbursement .
Does CMS count domains in PQRS?
Depending on the PQRS measures you reported, there may be domains that do not contain quality measures. CMS does not count these domains toward the group's composite score; only the domains with measures are used to calculate the standardized score.
