2010 PQRI for Neurologists: Learn How to Earn Your 2 Bonus Thursday, March 4, 2010 11:30am-12:30pm ET

1. 2010 PQRI for Neurologists: Learn How to Earn Your 2% Bonus Thursday, March 4, 2010 11:30am-12:30pm ET

2. Speakers Michael T. Rapp, MD, JD, FACEP Director, Quality Measurement and Health Assessment Group Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services Rita Richardson, MD, FAAN Member, AAN Quality Measures and Reporting Subcommittee Medical Director, Musculoskeletal Division Altru Health System, Grand Forks, ND

3. Overview Reporting options Key elements of PQRI performance measures and specifications Which measures apply to your practice How to earn the 2% bonus Feedback report and incentive payment Techniques and new tools for PQRI 2010

4. 2010 PQRI The Physician Quality Reporting Initiative (PQRI) program requirements and measure specifications are modified yearly Voluntary Pay-for-reporting program Effective January 1, 2010 through December 31, 2010

5. How Do I Participate? Voluntary program No need to register with CMS Just start reporting the measures

6. Why participate Future reimbursement tied to outcomes Neurologists provide high quality, efficient care Demonstrate the value of that care 2% bonus payment Preparation for Maintenance of Certification (MOC)

7. PQRI Bonus Earn a 2% bonus payment on your total Medicare Part B Physician Fee Schedule (PFS) allowed charges Bonus paid to holder of TIN mid-2011; analysis & feedback occurs at NPI level

8. Quality Measure Specifications Denominator – ICD-9 and/or E/M codes identify pts/visits that a measure is applicable Numerator – CPT II codes translate the clinical actions related to each reported measure Modifiers – explain rationale behind the clinical action being reported

9. Reporting Methods Claims Qualified Registry http://www.cms.hhs.gov/ERxIncentive/Downloads/QualifiedRegistriesPhase1eRx020110.pdf Qualified EHR http://www.cms.hhs.gov/ERxIncentive/Downloads/QualifiedEHRVendorsRvsd02022010.pdf

10. New Group Practice Reporting Option A group practice can qualify to earn PQRI incentive payment equal to 2% of the group practice's total estimated Medicare Part B FFS allowed charges for covered professional services furnished during a 2010 PQRI reporting period http://www.cms.hhs.gov/PQRI/Downloads/GPRO_SelfNominationRequirements_111009.pdf

11. Stroke Measures

14. Retired PQRI Measurement Specifications

15. Example Measure 32: Stroke, Discharged on Antiplatelet Therapy Eligible patients: Aged 18 or older with ischemic stroke or TIA Report eligible ICD-9 code from list (e.g., 433.01) Report CPT code for initial hospital visit (e.g., 99222)

16. CPT II Codes Oral antiplatelet therapy prescribed at discharge 4073F: Oral antiplatelet therapy prescribed at discharge Oral antiplatelet therapy not prescribed at discharge 4073F-1P: Medical reason for not prescribing oral antiplatelet therapy 4073F-2P: Patient reason for not prescribing oral antiplatelet therapy 4073F-8P: Not prescribed, no reason given

17. 1500 Form – Stroke Reporting

18. Individual Measures Claims-based reporting of individual measures (12 months) Registry-based reporting of at least 3 individual PQRI measures for 80% of applicable Medicare Part B FFS patients of each eligible professional (6 or 12 months) EHR based reporting of at least 3 individual PQRI measures for 80% of applicable patients (12 months)

19. Measure Groups – Claims Claims-based reporting of one measures group for: 30 consecutive Medicare Part B FFS patients (12 months) Claims-based reporting of one measures group for 80% of applicable Medicare Part B FFS patients of each eligible professional with a minimum of 30 patients during the reporting period (12 months) with a minimum of 15 patients during the reporting period (6 months)

20. Measure Groups – Registry Registry-based reporting of one measures group for: 30 consecutive patients (patients may include, but may not be exclusively non-Medicare patients)(12 months) 80% of applicable Medicare Part B FFS patients of each eligible professional with a minimum of 30 patients during the reporting period (12 months) with a minimum of 15 patients during the reporting period (6 months) No EHR-based option for measure groups

21. Back Pain Measure Group 13 total Measure Groups-- Back Pain most relevant Must report all 4 measures #148: Back Pain: Initial Visit #149: Back Pain: Physical Exam #150: Back Pain: Advice for Normal Activities #151: Back Pain: Advice Against Bed Rest Claims-based or registry reporting

22. AAN’s Role with Quality Measures Measure Development Call for Measures through AMA or NQF Quality Measures and Reporting committee implements process for measure development Convenes panel Uses Evidence-based Data Vetting to physician populations society wide Submission to AMA or NQF Current measures at work Epilepsy, Parkinson’s

23. AAN Participation Tools

24. CMS Participation Tools CMS PQRI Website http://www.cms.hhs.gov/PQRI CMS PQRI Implementation Guide http://www.cms.hhs.gov/PQRI/Downloads/2010_PQRI_ImplementationGuide_02-10-2010_FINAL.pdf

25. Questions? Email p4p@aan.com