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PQRI Panel Discussion

PQRI Panel Discussion. MGMA St. Louis April 8, 2009. Format. Panelists. Agenda. What is PQRI Questions for Panel Valuable Links & Resources Example Flow Chart (pdf). Joyce Borton – Metro Heart Group Kathi Enger – Esse Health Ron Finnan – St. Elizabeth’s Hospital

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PQRI Panel Discussion

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  1. PQRI Panel Discussion MGMA St. Louis April 8, 2009

  2. Format Panelists Agenda What is PQRI Questions for Panel Valuable Links & Resources Example Flow Chart (pdf) • Joyce Borton – Metro Heart Group • Kathi Enger – Esse Health • Ron Finnan – St. Elizabeth’s Hospital • Marie Tiberend – BJC Medical Group • Mike Capizzi - Facilitator

  3. PQRI • Physician Quality Reporting Initiative • 2006 TRHCA established a physician quality reporting system; incentive payment for eligible professionals who satisfactorily report data on quality measures through submission of part B claims for Medicare beni’s

  4. Design • How did you first decide to engage in PQRI? • Who was involved in the decision making process? • What pro’s and con’s were discovered/discussed? • Why did you decide to participate? • What resources were identified and needed?

  5. Measure / Analyze • What measures did you decide to report on? Why? • Within measure specs, what do numerators and denominators consist of? • What are code modifiers? • Describe the difference between CPT I, CPT II code modifiers and QDCs. • How do clusters affect reporting of measures? • How did you submit – claims or registry based? • What is MAV (Measure Applicability Validation)?

  6. Improve / Control • What was the result? • What were you’re main challenges? How did you overcome them? • How has your practice changed since? • What would you do differently?

  7. Reporting ‘08 Pilot Listing of EMR Vendors: ‘08 Qualified Registries: See link, next slide • Cerner Corporation • eClinicalWorks • NextGen Healthcare Information Systems, Inc. • DocSite • Allscripts • Anceta

  8. Links / Resources • CMS PQRI: http://www.cms.hhs.gov/PQRI/01_Overview.asp#TopOfPage • List of EP’s: http://www.cms.hhs.gov/PQRI/10_EligibleProfessionals.asp#TopOfPage • ‘09 Measure Specs Manual: http://www.cms.hhs.gov/PQRI/15_MeasuresCodes.asp#TopOfPage • ‘08 Qualified Registries: http://www.cms.hss.gov/PQRI/Downloads/PQRIQualifiedRegistries.pdf • AMA: http://www.ama-assn.org/ama/no-index/physician-resources/17432.shtml • NCQA: http://www.ncqa.org/tabid/74/Default.asp • CMS 2009 PQRI Update Call; 4/22/09; 1:30PM Central: http://www2.eventsvc.com/palmettogba/042209

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