PQRS – Physician Quality Reporting System

Why is PQRS important to you?

To help ensure that our patients get the right care at the right time, Five Star Physician Services participates in the Physician Quality Reporting System (PQRS).  PQRS is a CMS quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care they provide to patients with Medicare Part B insurance. PQRS is a voluntary program.

By reporting on PQRS quality measures, individual EPs and group practices can also quantify how often they are meeting a particular quality metric. Beginning in 2015, the PQRS program began applying a negative payment adjustment to individual EPs and PQRS group practices who did not satisfactorily report data on quality measures for Medicare Part B Physician Fee Schedule (MPFS) covered professional services in 2013. Those who reported satisfactorily for the 2015 program year will avoid the 2017 PQRS negative payment adjustment. Five Star EPs successfully submitted on the Dementia Measures Group in 2015 and are currently working on PQRS for 2016 to avoid the 2018 PQRS negative payment adjustment which would be 2% for the EP and 4% for the group practice.

Why is PQRS important to you? The program is voluntary, but for those physician practices and individual physicians that do not participate, they will be negatively impacted ECONOMICALLY. They will not be reimbursed at their traditional amounts, and it will impact their ability to keep and hire top physicians.

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