Quality and Regulatory Affairs (QRA) works with several ASA committees and other stakeholders to ensure members have the opportunity to satisfactorily participate in federal quality reporting programs. Quality programs often change from year-to-year and QRA educates members and their practices on regulatory aspects of such programs.
Please visit the QRA webpages below for additional information on the following quality reporting programs:
- Physician Quality Reporting System (PQRS)*: PQRS is a reporting program that uses negative payment adjustments to promote reporting of quality information by eligible professionals (EPs).
- Electronic Health Records (EHR) Incentive Program*: The EHR Incentive Program is overseen by CMS for physicians participating in the Medicare component and individual state Medicaid agencies for physicians participating in the Medicaid program. The EHR Incentive Program uses payment incentives and payment adjustments to encourage the adoption, implementation and use of certified EHR technology.
- Physician Compare: Physician Compare is a website maintained by CMS and is aimed at assisting Medicare patients in making informed decisions about their care by identifying and comparing healthcare professionals.
- Value-Based Payment Modifier (VM)*: A budget neutral program based on relative quality and cost of care. Medicare adjusts physician payments using quality data from the Physician Quality Reporting System (PQRS) and cost data from Medicare claims for fee-for-service patients.
* The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaced the Physician Quality Reporting System (PQRS), the EHR Incentive Program and the Value-Based Payment Modifier (VM) with three distinct components of the Merit-based Incentive Payment System (Quality, Advancing Care Information and Cost, respectively).
Members will continue to be impacted by each of these former programs:
- PQRS: Members will receive either a negative or neutral adjustment in payment years 2017 and 2018 on their Part B covered professional services under the Medicare Physician Fee Schedule (MPFS) based upon their calendar year 2015 and 2016 PQRS participation.
- EHR Incentive Program: Physician anesthesiologists with a PECOS designation of "05" maintain a hardship exemption for calendar year 2015 and 2016. Physician anesthesiologists should not see an adjustment based upon the EHR Incentive Program in payment years 2017 or 2018.
- VM: Members will receive a neutral, negative or positive adjustment to their Medicare payments for items and services under the Medicare Physician Fee Schedule in payment year 2017 and 2018 based upon their participation in PQRS and assessment of their VM based upon calendar year 2015 and 2016 data.