Centers for Medicare & Medicaid Services (CMS) Allowing Specialty Society Registries To Submit Quality Data to PQRS


Hospitalists shouldn't get too excited over the recent decision by the Centers for Medicare & Medicaid Services (CMS) that allows specialty society-run clinical data registries to submit their own quality metrics under the Physician Quality Reporting System (PQRS).

CMS earlier this month agreed to let specialist medical societies draw up their own quality measures, but to qualify, societies must have a certified clinical data registry. SHM’s Public Policy Committee (PPC) and Performance Measurement and Reporting Committee (PMRC) consistently provide feedback to CMS on the current PQRS quality measures and is reviewing the potential value of a clinical data registry for SHM members in the future.

PPC and Team Hospitalist member Joshua Lenchus, DO, RPh, FACP, SFHM, says he and other hospitalist leaders will discuss CMS' decision, but he wonders whether the reporting system's average payment adjustment for foreseeable program years and hospitalist interest is high enough to make establishing a data registry worthwhile. “The question begs,” Dr. Lenchus says, “is the benefit worth the effort?”

The 2014 Medicare physician fee schedule [PDF] reported that 26,515 medical practices with 266,521 eligible professionals participated in PQRS in 2011—or about 27% of eligible providers. SHM has encouraged its members to participate since the system's inception in 2007 to both take advantage of incentive payments that were available and to prepare for upcoming penalties for failure to report. Starting in 2015 and based on 2013 performance, there will be a penalty for not reporting PQRS quality measures.

Dr. Lenchus says PPC members will continue to monitor and advocate for quality metrics that are more in line with daily hospitalist duties. Similarly, SHM's Performance Measurement and Reporting Committee (PMRC) has been working to identify and ensure measures applicable to HM are included in PQRS.

"The committee is deeply concerned about the limited number of PQRS measures broadly applicable to hospitalists, and we are working to change this disparity," wrote Greg Seymann, MD, SFHM, chief of the division of hospital medicine at the University of California at San Diego and chair of SHM’s PMRC, and Josh Boswell, SHM’s senior manager of government relations in The Hospitalist last month.

Dr. Lenchus adds that while SHM and other societies can weigh in on the measures, CMS remains the final arbiter.

"Groups will submit whatever metrics they would like to be assessed against and those metrics will not be taken carte blanche, but rather will require CMS approval," he says.

Visit our website for more information about PQRS.

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