| Many physician practices are gearing up for a full year of participation in The Centers for Medicare and Medicaid Services (CMS) Physician Quality Reporting Initiative (PQRI), now in its third year. While participation in PQRI is voluntary for now, many health plans are modeling their own quality reporting and physician reimbursement processes processes on this CMS initiative. Eventual mandatory participation in PQRI is expected, as is PQRI’s impact on traditional physician reimbursement models.
This special report, 2008 Physician Quality Reporting Guide: Essentials of Data Collection, Work Flow Optimization and Physician Engagement for Practices, introduces the 2008 PQRI changes and offers strategies and templates to optimize practice work flow and turn PQRI participation into profit. From the perspectives of the physician, administrator and coder, three thought leaders in the quality and measures reporting arenas describe how to streamline data collection, overcome barriers to staff and physician participation and monetize the measures to increase physician practice revenue streams while enhancing patient care. Even for practices who have not yet adopted electronic medical records, it is still advantageous to participate in PQRI, these experts say. This special report provides a range of Web-based PQRI resources and tools to enhance participation.
In this 35-page report, you'll get invaluable suggestions for work flow improvement, from the pre-office visit process to tasks performed by the physician, back office and coder. Contributing authors Dr. Bruce Bagley, medical director of quality improvement with the American Academy of Family Physicians, which represents more than 100,000 physicians and medical students;
Sue Kincer, consultant and certified professional coder with Pershing Yoakley & Associates, P.C.; and
Lorraine K. Larrance, consulting senior manager with Pershing Yoakley & Associates,P.C., share details on:
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What's new in 2008 — new and retired measures and emerging opportunities for non-physicians to participate
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The "new money" rewards of PQRI and revenue enhancement strategies
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Insider coding essentials and tips
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Cultivating the PQRI practice champion
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Overcoming the four key barriers to physician participation
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Automating data collection — with or without an EHR
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Leveraging PQRI participation for other quality programs
- and much, much more, including five pages of valuable PQRI process improvement tools, worksheets and resources to enhance physician practice reporting efficiency.
Table of Contents
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Redesigning Work Flow for a New Physician Payment Environment
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Measures Development, Endorsement and Implementation
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Increasing Revenue Using PQRI
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Common Misunderstandings About Clinical Measures
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PQRI and Physician Payment
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Why Participate in PQRI
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Making a Case for Physician PQRI Participation
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Four Barriers to Physician Participation in PQRI
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Reducing Physician Resistance to Change
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Engaging Physicians in a New Process
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Essentials of an Effective PQRI Practice Team
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Guidelines for Measures Selection
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Work Flow Modifications
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Confidential PQRI Feedback Reports
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PQRI Coding Principles
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Sample Review Steps for Work Flow Process
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Q&A: Ask the Experts
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Measures for Podiatrists
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NPI vs. Tax ID Number Use in PQRI
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Most-Reported Measures
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Factoring in Patient Refusal
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When to Perform Measures During Patient Visits
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Bonus Payments for 2007
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Getting Physicians on Board
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Cultivating Practice Champions
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Appendix: Sample PQRI Work Flow Process Review Tool
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