Need to Know: EHR reporting for PQRS in 2015

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As more and more medical practices are adopting electronic health records (EHRs) and using them as a routine part of delivering patient care in the ambulatory setting, CMS has created reporting mechanisms that leverage EHR data for quality measurement and reporting. After a couple years as a pilot program only open to select EHR vendors, the PQRS EHR reporting mechanism is now available to all eligible professionals and group practices using a 2014 Certified EHR.

PQRS participation using the EHR reporting mechanism is very different from other PQRS reporting options, because it is limited to the electronic clinical quality measures (eCQMs) that are supported by EHR systems. For a list of PQRS eCQMs, which are called the 2014 CQMs for Eligible Professionals, refer to the CMS eCQM Library. Providers and group practices electronically reporting PQRS using an EHR are required to use the July 2014 updated version of the 2014 eCQMs for the 2015 program year.

Eligible professionals and group practices who registered with CMS before June 30, 2015 must meet the EHR reporting requirements that are aligned with the Medicare EHR Incentive Program in order to avoid the 2017 PQRS negative payment adjustment. CMS has aligned the following reporting requirements for these two programs in order to reduce the administrative reporting burden:

  • Using a EHR product that is Certified EHR Technology (CEHRT), report on at least 9 quality measures covering three National Quality Strategy (NQS) domains
  • If your certified EHR does not contain patient data for at least 9 measures covering at least three NQS domains, then you must report the measures for which there is Medicare patient data
  • Providers must report at least one measure for which there is Medicare patient data

Eligible professionals and group practices must submit final electronic reporting files with quality measure data, or ensure that their EHR Data Submission Vendor submits files by the data submission deadline of February 29, 2016, to be analyzed and used for 2015 PQRS EHR measure calculations. Electronic files for eCQMs reported as part of PQRS participation must be formatted as either a Quality Reporting Data Architecture (QRDA) Category I or Category III .xml file. For more information on reporting PQRS using the Direct EHR reporting mechanism or Data Submission vendor EHR reporting mechanism, refer to the CMS Electronic Reporting Using an EHR web page.

Further reading:
How using the MIPS 90-day reporting period will increase your 2017 Composite Score
Avoiding a penalty in 2018 MIPS: the nuts and bolts

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