Quality and Resource Use Reports: Key Considerations … and Resource Use Reports: Key...
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Quality and Resource Use Reports: Key Considerations in Optimizing MIPS performance Doral Jacobsen, MBA FACMPE CEO - Prosper Beyond, Inc. prosperbeyond.com Thursday – March 9, 2017 (12:00 – 1:15 pm Pacific / 1:00 – 2:15 pm Mountain / 2:00 – 3:15 p.m. Central / 3:00 – 4:15 pm Eastern)
Transcript of Quality and Resource Use Reports: Key Considerations … and Resource Use Reports: Key...
Quality and Resource Use Reports:
Key Considerations in Optimizing
MIPS performance
Doral Jacobsen, MBA FACMPE
CEO - Prosper Beyond, Inc.
prosperbeyond.com
Thursday – March 9, 2017(12:00 – 1:15 pm Pacific / 1:00 – 2:15 pm Mountain / 2:00 – 3:15 p.m. Central / 3:00 – 4:15 pm Eastern)
Understand how to access Quality and Resource Use
Reports (QRURs).
Define key indicators in QRURs that can inform a
MIPS strategy.
Identify drill-down data available in QRUR exhibits
and tables.
Describe sample analyses that can be calculated
using QRUR data.
Summarize how information in QRURs can be used to
optimize MIPS performance.
LEARNING OBJECTIVES
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Foundational Framework
Connecting the Dots – MACRA and Value Modifier
QRUR
Accessing Reports
Components
Exhibits & Tables
QRUR Data and Performance in MIPS
AGENDA
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FOUNDATIONAL FRAMEWORK
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CMS PAYMENT FRAMEWORK
The framework situates
existing and potential
alternative payment
models (APMs) into a
series of categories.
Source: Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group. “Alternative Payment Model (APM) Framework Final White Paper.” Health Care Payment Learning and Action Network. 12 Jan. 2016.
WHERE ARE WE HEADED?
6Source: Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group. “Alternative Payment Model (APM) Framework Final White Paper.” Health Care Payment Learning and Action Network. 12 Jan. 2016.
MACRA MOVES US CLOSER…
7Source: CMS MACRA presentation Spring 2016
CONNECTING THE DOTSMACRA AND THE VALUE MODIFIER
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Bipartisan-passed legislation
Ends the sustainable growth rate (SGR)
formula for determining Part B payments
Establishes a new framework for the
Quality Payment Program (QPP) which rewards health care providers
for giving better care—not just more care (MIPS and APM)
Sunsets existing programs – PQRS, Value Modifier (VM), Meaningful
Use (MU), eRx
Provides consistent physician-fee schedule increases (0.5% from 2015
through 2019)
Establishes an advisory committee for assessing physician-focused
payment model proposals
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MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA)
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Starting in 2019 (with the 1st performance period starting 1/1/17),
all eligible clinicians will fall into one of two categories under
MACRA’s QPP:
Merit –Based Incentive Payment System (MIPS) Advanced Alternative Payment Models (APM)
Portion of practice Medicare revenue at risk at tax ID or
individual levels based on performance in these categories:
* Awaiting final rule (comment period open), partially qualifying APM status available and starting in 2021 non-Medicare revenue/patients included
Initial Advanced APMs:
Comprehensive Primary Care Plus (CPC+)
MSSP Tracks 2 & 3
Next Gen ACO
Comprehensive ESRD Care Model (CEC)
Comprehensive Joint Replacement (CJR)
No downside risk on Part B fee schedule if thresholds are
achieved through an “Advanced” APM:
Source: CMS Final MACRA Rule October 2016
Measure CategoryYear 1 (2019)
Year 2 (2020)
Year 3 (2021)
Quality(aka PQRS)
60% 50% 30%
Cost - Resource Use (aka VM)
0% 10% 30%
Advancing Care Information (aka MU)
25% 25% 25%
Improvement Activities(IA - New)
15% 15% 15%
MIP
S A
PM
s a
nd
Pa
rtia
lly Q
ua
lifie
d
MACRA: QUALITY PAYMENT PROGRAM
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MACRA: QPP MIDDLE GROUND MIPS APM WEIGHTS
MIPS APMs – All MSSPs & Next Gen ACOs
Improvement Activities, 20%
ACI, 30%
Quality, 50%
MIPS APMs – All OthersImprovement
Activities, 25%
ACI, 75%
Does not
include cost
Does not include
quality or cost
Payment Amount
2019 to
2020
2021 to
2022 2023 +
QP % Payments 25% 50% 75%
Partial QP %
Payments 20% 40% 50%
QP All Payer %
Payments NA 50%/*25% 75%/*25%
Partial QP All
Payer % Payments NA 40%/*20% 50%/*20%
Patient Amount
2019 to
2020
2021 to
2022 2023 +
QP % Patients 20% 35% 50%
Partial QP %
Patients 10% 25% 35%
QP All Payer %
Patients NA 35%/*20% 50%/*20%
Partial QP All
Payer % Patients NA 25%/*10% 35%/*10%
Partially Qualifying Eligible Clinicians – AAPM
Source: CMS Final MACRA Rule October 2016
MACRA Economic Impact
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2019 2020 2021 2022 MIPS
-4% -5% -7% -9%
+1%est. +5% +7% +9% +5% +5% +5% +5%
2019 2020 2021 2022
No downside risk – provider level
AAPM
Report nothing receive a -4% penalty Report one measure for zero adjustmentReport more than one measure to receive some increase and if 70+ points
you’re eligible for $500 million – non revenue neutral – .5% to 10% Participate in an AAPM receive 5% lump sum bonus
From 2019 forward, providers will not be paid the same for
services provided to Medicare beneficiaries.
2017 Transition Year Options:
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MACRA: GOAL 2017 – ADMISSION TO THE “70+" CLUB…
CMS QUALITY PROGRAMS: Part B
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Impact Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2026
and
Beyond
Performance Period 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 TBD
Value Modifier Groups >
100 Eligible Professional
(EPs)
(-1.5%) to
9.8% (-2%) to
2(x*)%(-4%) to 4(x*)%
Transitioned to Merit-Based Incentive Payment System (MIPS)
Groups > 10 EPs
Groups 1-9 EPs(-2%) to
2(x*)%
(-4%) to
2(x*)%
Meaningful-Use
Penalties(-1%) (-2%) (-3%)
(-3 to -
4%)
PQRS Penalties (-2%)
Total (from above):(-4.5%) to
9.8%
(-6%) to
2(x*)%
(-9%) to
4(x*)%
(-10%)
to
4(x*)%
Advanced Alternative
Payment Model (AAPM)No MIPS Risk: 5% Lump-Sum Payment
Merit-Based Incentive
Payment System (MIPS)
(-4.5%)
to 4% +
HP**
(-5%) to
5% to +
HP**
(-7%) to
7% to
HP**
(-9%) to
9% to +
HP**
(-9%) to
9% to +
HP**
(-9%) to
9% to +
HP**
(-9%) to
9% to +
HP**
(-9%) to
9% to +
HP**
Fee Schedule Updates
(All)0.50% 0% Increase
Fee Schedule Updates
(MIPS)0.25%
Fee Schedule Updates
(AAPM)0.75%
** High Performers (HP) $500 million +
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CONNECTING THE DOTSMACRA AND THE VALUE MODIFIER
Major Components
Applied by Tax Identification
Number (TIN) and patients by
PCP and/or plurality
VM = Quality 50% & Cost 50%
(60%+ of MIPS)
Claims-Based Outcome
Scores
Quality and Resource Use
Reports (QRURs)
Quality Tiering
LowQuality
AverageQuality
HighQuality
LowCost
0%(6 groups)
+16%(35 groups)
+32%(38 groups)
+32%(38 groups)
+48%(0 groups)
AverageCost
-1%(37 groups)
0%(8,201 groups)
+16%(35 groups)
+32%(20 groups)
HighCost
-2%(2 groups)
-1%(20 groups)
0%(1 groups)
Impact to Medicare
Reimbursement 2016
12016 Adjustment Factor 2Calculated as 2.0x adjustment factor for high risk beneficiaries 3Calculated as 3.0x adjustment
factor for high Risk beneficiaries 4TINs with 10-99 eligible physicians do not receive downward adjustments under quality
tiering in 2016 Source: CMS 2016 VM Overview PDF Memo, CMS 2016 VM OACT Adjustment Factor PDF Memo
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QUALITY AND RESOURCE USE REPORTS (QRURS)
ACCESS QRUR – STEP 1: EIDM SET UP
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Obtain an enterprise identity data management (EIDM) account with the correct role:
Security official group/Group representative
Individual practitioner/Individual practitioner representative
Gather information needed to register (time limit on screens is 25 minutes).
Navigate to https://portal.cms.gov/ and select New User Registration.
Once approved, log in to the CMS portal and complete the multi-factor authentication (MFA) required. This will need to be entered each time you log in (security code/device).
Questions can be addressedMon–Fri: 8:00 a.m.–8:00 p.m. EST.
Phone: (866) 288-8912; TTY: (877) 715-6222; and/orEmail: [email protected]
See quick reference guide.
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ACCESS QRUR – STEP 2: DOWNLOAD REPORT AND TABLES
Navigate to https://portal.cms.gov and select Login to CMS Secure Portal.
Read the “Terms and Conditions” and select “I Accept.”
Enter your EIDM user ID and select “Next.”
Complete the MFA process and enter your EIDM password to continue.
Select Feedback Reports from the PV-PQRS dropdown menu.
Select 2015 from the “Select a Year” dropdown menu.
Select the 2015 Annual Quality and Resource Use Report (QRUR).
To access tables, choose “Select a Report” from the dropdown menu.
Questions can be addressed Mon–Fri: 8:00 a.m.–8:00 p.m. EST.
Phone: (888) 734-6433 (Option 3); TTY: (888) 734-6563;
and/or Email: [email protected].
See quick reference guide
QRUR AND MIPS
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Quality ofCare
Composite Score50%
CostComposite Score 50%
VALUEMODIFIER
ADJUSTMENTAMOUNT
Clinical Care
Patient Experience
Population/Community Health
Patient Safety
Care Coordination
Efficiency
Total Per-Capita Costs (Plus MSPB)
Total Per-Capita Costs for Beneficiaries with Specific Conditions
Readmissions
Chronic Composite
Acute Composite
Total Per Capita
MSPB
Episodes
Cla
ims-B
ase
d O
utc
om
es
MIPS
Va
lue
Mo
difie
r C
ate
go
ries
Other Quality Measures
New
QRUR - BACKGROUND
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Attribution Methodology
Based on primary care services
If no primary care services then assigned regardless of specialty
For MSPB – based on plurality of claims
Peer Groups
Minimum Case Size = 20, 125 MSPB or 200 Readmissions
Risk Adjustment – Hierarchical Coding Categories (HCCs) Used
Five Exhibits + Seven Tables and 14 tabs (Excel)
QRUR First Few Pages
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• Shows how your TIN compares to
peer groups in quality and cost
• Yellow – One (1) Standard
Deviation from the mean
• High-risk bonus adjustment
Your TINs 2017 Value Modifier & Risk Adjustment
EXHIBITS 1 & 2
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Indicates penalty or incentive
for the entire year at the TIN
level
Value Modifier Adjustment
Quality Composite
Indicates how your practice
performed relative to peers--
quality
Higher numbers are better
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
EXHIBIT 3
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PQRS Measures
MIPS – grades on curve
Claims-Based Outcome
Measures
Thresholds
20 case minimum
200 for readmissions
Lower numbers are better
(outcome measures)
Performance Quality Measures
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
EXHIBITS 4 & 5
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Indicates how your practice
performed relative to peers—
cost
Lower numbers are better
Cost Composite
Cost by Attribution (Per Capita & MSPB)
Indicates how your TIN
compares to peers in cost
measures
Lower numbers are better
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
Summary: Number of Eligible Professionals in Your TIN
Number Identified via
PECOS†
Number Identified via
Billings†
All eligible professionals 19 16
Physicians 12 6
Non-physicians 7 7
NPI Name Physician† Non-
Physicia
n Eligible
Professio
nal†
Specialty
Designation†
Identified via
PECOS†
Identified via
Billings†
Date of Last Claim
Billed Under TIN
XXX Dr A Yes No Nephrology Yes No --
XXX Dr B Yes No Vascular Surgery Yes Yes 12/31/2015
TABLE 1
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Key Elements:
Physicians and non-physician eligible
professionals identified in TIN
Identified through claims or PECOS
Action Steps:
Validate providers
Update PECOS as necessary at
https://pecos.cms.hhs.gov/pecos/login.do.
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
TABLES 2A, 2B & 2C
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Key Elements:
2A beneficiaries attributed for cost measures
(except MSPB) and claims-based outcome
measures
2B admitting hospitals
2C hospital admissions
Action Steps:
Confirm patients
Review HCCs and cost by provider
Examine services inside/outside your TIN–
care coordination opportunities
Compare providers at
https://www.medicare.gov/physiciancompare/
Assess follow-up care after hospital stay
Evaluate care management opportunities for
patients with chronic conditions
Hospital Name
Hospital CMS
Certification
Number
Hospital
Location Number of Stays Percentage of All Stays
Total 143 100.00%
Hospital A XXXX XXXX 61 42.66%
Hospital B XXXX XXXX 13 9.09%
Hospital C XXXX XXXX 12 8.39%
Hospital D XXXX XXXX 11 7.69%
Hospital E XXXX XXXX 9 6.29%
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
TABLES 3A & 3B, 4A – 4D
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Key Elements:
3A summary per capita costs by
category (except MSPB)
3B cost details by beneficiary
4A – 4D: Same as 3A by specific
condition
Action Steps:
Review cost categories in total
and by provider compared to peer
groups
Examine services inside/outside
your TIN–care coordination
opportunities
Understand cost implications of
care setting (i.e., post acute
spend)
Evaluate care management
opportunities for patients with
chronic conditions
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
Your TIN All TINs in Peer Group†
How
Much
Higher
or
(Lower)
Your
TIN's
Costs
Were
than
TINs in
Peer
Group
Service Category
Number of
Attributed
Bene-
ficiaries
Using Any
Service in
this
Category
% of
Bene-
ficiaries
Using Any
Service in
this
Category
Per-Capita
Costs for
Attributed
Bene-
ficiaries†
Benchmark
(National
Mean)
Percentage of
Beneficiaries
Using Any
Service in
This Category
Benchmark
(National
Mean) Per-
Capita
Costs
ALL SERVICES 235 100.00% $10,085 100.00% $12,326 ($2,241)
Outpatient evaluation and
management services,
procedures, and therapy
(excluding emergency
department) 235 100.00% $1,480 100.00% $1,962 ($482)Evaluation & management
services billed by eligible
professionals 235 100.00% $924 99.99% $1,163 ($239)
Billed by Your TIN 235 100.00% $262 99.98% $495 ($240)
Primary care physicians 208 88.51% $190 62.06% $346 ($156)
Medical specialists 83 35.32% $64 18.02% $54 $10
Surgeons 0 0.00% $0 8.06% $21 ($21)
Other eligible professionals 15 6.38% $8 20.41% $81 ($73)
TABLES 5A – 5D
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Key Elements:
5A admitting hospitals MSPB measure
5B beneficiary level information for each
episode of care
5C summary cost per episode by category
of service
5D details cost per episode by category of
service
Action Steps:
Review principal diagnosis for high-cost
episodes
Evaluate communication opportunities
with facilities
Assess follow-up care after hospital stay
Compare facilities at
https://www.hospitalcompare.hhs.gov
Evaluate care management opportunities
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
Beneficiaries and
Episodes Attributed
to Your TIN for the
MSPB Measure
Total
Payment-
Standardized
Episode Cost
†
Medicare Spending per Beneficiary, by Category of Service, Furnished
by All Providers
Index †
HCC
Percentile
Ranking†
Acute
Inpatient
Hospital:
Index
Admission†
Acute
Inpatient
Hospital:
Readmission
Eligible
Professional
Services Billed
by Your TIN
During Index
Hospitalization
†
Eligible
Professional
Services Billed
by Other TINs
During Index
Hospitalization
†
Other
Physician or
Supplier Part B
Services Billed
During Any
Hospitalization
XXXX 99 $41,597 $9,450 $8,021 $420 $805 $775
XXXX 97 $16,801 $8,738 $0 $203 $182 $0
XXXX 97 $26,529 $6,430 $8,745 $852 $1,564 $1,209
TABLES 6A – 6B & 7
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Key Elements:
6A hospital admission for any cause –
beneficiaries attributed for cost measures -
Shared Savings Program only
6B hospital admission for any cause -
beneficiaries attributed for readmissions –
Shared Savings Program only
7 PQRS individual performance
Action Steps:
Review cost categories in total and by
provider compared to peer groups
Examine services inside/outside your
TIN–care coordination opportunities
Understand cost implications of care
setting - post acute spend
Evaluate care management opportunities
for patients with chronic conditions
CMS Website : HOW TO UNDERSTAND YOUR 2015 ANNUAL QUALITY AND RESOURCE USE REPORT
Characteristics of Hospital Admission Discharge Disposition
Date of
Admission
CMS
Cert.
Number
Principal Diagnosis †
(Code, Description)
Followed by Unplanned
All-Cause Readmission
Within 30 Days of
Discharge †
Date of
Discharge
Discharge
Status †
(Code,
Description)
03/16/2015 XXXXX 49121 Obs chr bronc w(ac)
exac
No 02/19/2015 01 Disch
Home
05/14/2015 XXXXX 42833 Ac on chr diast hrt fail Yes 05/20/2015 01 Disch
Home
05/29/2015 XXXXX 49121 Obs chr bronc w(ac)
exac
Yes 06/04/2015 01 Disch
Home
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QRUR DATA AND PERFORMANCEIN MIPS
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60% Quality – PQRS Measure
#110 - Preventive care and screening: Influenza immunization
Reduce Readmissions
15% Improvement Activity (IA)
*Expanded patient access
25% ACI
*End-to-end bonus points if IA reported using CEHRT
Immunization registry reporting worth up to 10 points
0% Cost – Prep next year but fold into strategy
Reduce avoidable admissions
Other – Bill for CPT codes
Chronic care management 99490 – complex 99487 and 99489
After hours/weekends 99050 and 99051 (commercial)
Prep for AAPM – Patient access points for PCMH
SAMPLE ANALYSIS #1 AVOIDABLE ADMISSIONS
Lead EP
Admission Via the ED
ACSC Admission
Unplanned All-Cause Readmission Within 30 Days of
Discharge
Dr A 2 2 0
Dr B 1 0 1
Dr C 1 1 2
Dr D 0 0 0
Dr E 6 2 0
Dr F 8 5 3
Dr G 2 0 0
Dr H 0 0 0
Dr I 11 5 2
Grand Total 31 15 8
SAMPLE ANALYSIS # 2 EPISODE
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60% Quality – PQRS Measure
#155 – Falls: Plan of Care
Reduce Readmissions
15% Improvement Activity (IA)
*Implementation of episodic care management
improvement
25% ACI
*End-to-end bonus points if IA reported using end-to-end
CEHRT
0% Cost – Prep next year but fold into strategy
Reduce avoidable admissions
Other – Bill for CPT codes
Transitional care management codes 99495 and 99496
Prep for AAPM – Improved care management
helps MSSPs and all other APMs
Follow-Up Visit - Post Inpatient
0
10
20
30
40
50
60
70
Dr A Dr B Dr C
# Episodes Follow up
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60% Quality – PQRS Measure
#122 – Adult kidney disease – Blood
pressure management
15% Improvement Activity (IA)
*Implement care plans – beneficiaries at
risk
25% ACI
*End-to-end bonus points if IA reported
using CEHRT
0% Cost – Prep next year but fold
into strategy
Reduce costs through deploying targeted
care management strategies
Other – Bill for CPT codes
Health assessment/Care planning G0506
Prep for AAPM – Diabetes
prevention program
SAMPLE ANALYSIS #3 COST BY CATEGORY SPECIFIC CONDITIONS
Table 4A. Per Capita Costs, by Categories of Service, for Beneficiaries with Diabetes
Service Category
Per Capita Costs
for Attributed
Beneficiaries†
Benchmark
(National Mean)
Per Capita Costs
How Much Higher
or (Lower) Your
TIN's Costs Were
than TINs in Peer
Group
ALL SERVICES $25,221 $18,273 $6,948
• Managed Care Contracting
Strategy
– Quality measure crossover
– Leverage focus on decreasing cost
– Quantify your value proposition
– Differentiate from competition
– QRUR is powerful data…especially
when presented at the clinician level
ONE STEP FURTHER…
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POSITION FOR MIPS USING QRUR DATA
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Steps to effectively using QRUR data to position in MIPS:
1) Access and download QRUR data as frequently as it is available.
2) Analyze QRUR data and share findings.
3) Identify areas of opportunity (i.e., PECOS, cost, quality, coding, clinical documentation etc.).
4) Determine any cross-over opportunities with MIPs categories and/or prep for APMs.
5) Include billing/coding opportunities in MIPS strategy development.
6) Work on cost this year – it’s about improving at a faster pace than the competition.
7) Deploy a MIPS monitoring system to track progress internally.
8) Work closely with your vendors – they are critical to a successful strategy.
9) Apply your strategies/measures to all populations and translate to commercial contracts.
10) Consider incorporating elements into future compensation formulas – start now
Doral Jacobsen, MBA FACMPE
CEO - Prosper Beyond, Inc.
(828) 231-1479
prosperbeyond.com
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To Complete the Program Evaluation
The URL below will take you to HFMA on-line evaluation form.
You will need to enter your member I.D. # (can be found in your
confirmation email when you registered)
Enter this Meeting Code: 17AT14
URL: http://www.hfma.org/awc/evaluation.htm
Your comments are very important and enables us to bring you
the highest quality programs!
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Technical Assistance: Call (888) 734-6433 (press option 3) or email [email protected]
QUICK ACCESS GUIDE FOR THE 2015 ANNUAL QRURS AND TABLES
The 2015 Annual Quality and Resource Use Report (QRUR) and Tables are available for all groups and solo practitioners nationwide, including those that participated in the Medicare Shared Savings Program, Pioneer Accountable Care Organization Model, or the Comprehensive Primary Care initiative in 2015. The 2015 Annual QRURs show how groups and solo practitioners, as identified by their Medicare-enrolled Taxpayer Identification Number (TIN) performed in
2015 on the quality and cost measures used to calculate the 2017 Value Modifier. For physicians in groups with two or more eligible professionals and physicians who are solo practitioners that are subject to the 2017 Value Modifier, the QRUR shows how the Value Modifier will apply to payments under the
Medicare Physician Fee Schedule for physicians who bill under the TIN in 2017.
A. ACCESSING YOUR TIN’S 2015 ANNUAL QRUR AND TABLES IN THE CMS ENTERPRISE PORTAL
Steps Screenshots
• Navigate to the CMS Enterprise Portal at https://portal.cms.gov and select ‘Login to CMS Secure Portal’.
• Read the ‘Terms and Conditions’ and Select ‘I Accept’.
• Enter your Enterprise Identity Management System (EIDM) ‘User ID’ and select ‘Next’.
• Complete the Multi-Factor Authentication (MFA) process and enter your EIDM ‘Password’ to continue.
• Select ‘Feedback Reports’ from the ‘PV-PQRS’ dropdown menu.
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Technical Assistance: Call (888) 734-6433 (press option 3) or email [email protected]
Steps Screenshots
• Select ‘2015’ from the ‘Select a Year’ dropdown menu, and then select the ‘2015 Annual Quality and Resource Use Report (QRUR)’ (or any one of the Tables) from the ‘Select a Report’ dropdown menu.
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Technical Assistance: Call (888) 734-6433 (press option 3) or email [email protected]
B. VIEWING YOUR TIN’S 2015 ANNUAL QRUR AND TABLES ONLINE
Steps Screenshots
• Select ‘View Online’ from the ‘Select an Action’ dropdown menu.
• Read the Attestation Message and make the appropriate selection.
• Select one TIN from the ‘Available’ TINs.
• Select ‘Run Document’.
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Technical Assistance: Call (888) 734-6433 (press option 3) or email [email protected]
C. NAVIGATING YOUR TIN’S 2015 ANNUAL QRUR ONLINE
Steps Screenshots
• The 2015 Annual QRUR contains the following sections that are displayed as tabs at the top of your report:
o About This Report (Default Tab) o Your TIN’s 2017 Value Modifier o Quality Performance o Cost Performance o Accompanying Tables o About the 2017 Value Modifier o Glossary
• Select the appropriate tab at the top of the screen to navigate to different sections of the report.
Note: If your TIN does not have a full Annual QRUR, then you will see information in the About This Report tab only. The remaining tabs will not display any information.
Note: Hyperlinks to the information related to the 2015 Annual QRUR are available throughout the report. Select any of the hyperlinks to access the related Tables, Glossary terms, and external websites.
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Technical Assistance: Call (888) 734-6433 (press option 3) or email [email protected]
D. DOWNLOADING YOUR TIN’s 2015 ANNUAL QRUR AND TABLES
Steps Screenshots
FROM WITHIN THE REPORT • Select the links on the ‘About this Report’ tab to download the
report in the following formats: o Portable Document Format (PDF) o 508 Compliant Excel Format o Comma Separated Value (CSV) Format
Note: If you use Internet Explorer (IE) as your web browser, please make sure the CMS Enterprise Portal (https://portal.cms.gov) is added to the browser’s trusted sites to prevent problems exporting your feedback report(s) to Excel. On the browser tool bar, go to Tools, select Internet Options, select the Security tab and then select Trusted Sites. On the Trusted Sites screen, click on the Sites button. If you don’t see the portal address in the list of trusted Websites click the Add button to add the portal address. Select Close and then OK to save and return to IE. Alternatively, you may use Chrome or Firefox as your browser, to view and export your report(s).
FROM THE PV-PQRS Portal
To download your 2015 Annual QRUR:
• Select ‘2015’ from the ‘Select a Year’ dropdown menu, and then select the ‘2015 Annual QRUR’.
• Select ‘Download this report in PDF Format’ from the ‘Select an Action’ dropdown menu to download your 2015 Annual QRUR.
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Technical Assistance: Call (888) 734-6433 (press option 3) or email [email protected]
Steps Screenshots
To download your 2015 Annual QRUR Tables:
• Select ‘2015’ from the ‘Select a Year’ dropdown menu, and then select the 2015 Annual QRUR Table.
• Select ‘Download this report in Excel Format’ from the ‘Select an Action’ dropdown menu to download your 2015 Annual QRUR Tables.
• Read the Attestation Message and make the appropriate selection.
Note: If you use Internet Explorer (IE) as your web browser, please make sure the CMS Enterprise Portal (https://portal.cms.gov) is added to the browser’s trusted sites to prevent problems exporting your feedback report(s) to Excel. On the browser tool bar, go to Tools, select Internet Options, select the Security tab and then select Trusted Sites. On the Trusted Sites screen, click on the Sites button. If you don’t see the portal address in the list of trusted Websites click the Add button to add the portal address. Select Close and then OK to save and return to IE. Alternatively, you may use Chrome or Firefox as your browser, to view and export your report(s).
• Select one TIN from the ‘Available’ TINs. • Select ‘Export’.
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Technical Assistance: Call (888) 734-6433 (press option 3) or email [email protected]
HELPFUL RESOURCES
Detailed instructions for obtaining an EIDM account and accessing the 2015 Annual QRURs and Tables are available at:
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Obtain-2013-QRUR.html.
More information about the 2015 Annual QRURs and 2017 Value Modifier is available at:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/2015-QRUR.html.
For questions about information contained in your TIN’s 2015 Annual QRUR or the Value Modifier, please contact the Physician Value Help Desk:
• Monday – Friday: 8:00 am – 8:00 pm EST
• (888) 734-6433 (press option 3); (TTY (888) 734-6563)
• Email: [email protected]
For questions about setting up an EIDM account, please contact the QualityNet Help Desk:
• Monday – Friday: 8:00 am – 8:00 pm EST
• (866) 288-8912 (TTY (877) 715-6222)
• Email: [email protected]
