2015-05-17 15:00:15 UTC

Session Will Help Physicians Make Sense of Quality Reporting Programs

May 17, 2015

Ziad F. Gellad, MD, MPH, will chair a special AGA symposium Monday, May 18, 2015, during DDW® 2015 .

This post originally appeared in DDW® Daily News

Quality reporting can be confusing to physicians. That confusion is one reason clinicians have been slow to accept and join quality reporting programs. AGA wants to transform the confusion into participation.

“One of the most significant problems with the current quality reporting system is that the value proposition to physicians is not clear,” said Ziad F. Gellad, MD, MPH, chair of the AGA Quality Measures Committee. “There’s over reliance on process measures rather than on clinically meaningful outcomes. It’s not easy to understand what measures are being collected. And penalties, so far, have been quite low. There has not been much risk in not reporting quality.”

But that low-risk, low-reward picture is changing, said Dr. Gellad, assistant professor of medicine at Duke University Medical Center in Durham, NC. The financial penalties for failing to report quality measures to the Centers for Medicare and Medicaid Services (CMS) are climbing. Meanwhile, payors in the private sector are adopting similar quality reporting requirements and patients are starting to use quality reporting to select providers.

To help clinicians adjust to these changes, Dr. Gellad will chair a special AGA symposium Monday, May 18, 2015, during Digestive Disease Week® (DDW) 2015 titled "Making Dollars and Sense of Quality: A How-to Guide for the Physician Quality Reporting System". The session, which will take place in the Walter E. Washington Convention Center in Washington, DC, is designed to give attendees a better understanding of how to use CMS’ Physician Quality Reporting System (PQRS) and how to use quality reporting to enhance their practices.

The program will focus on three clinical areas: hepatitis C, IBD and colorectal cancer screening. Expert presenters will distill PQRS and other federal reporting requirements to the key points that practicing gastroenterologists need to know and apply on a regular basis.

One key point: Not reporting quality measures becomes much more expensive this year.

Quality reporting emerged as a CMS initiative to improve quality and reduce the cost of care provided to Medicare beneficiaries. In the early stages of implementation, CMS offered financial incentives to report quality measures under PQRS. The agency is now rolling out financial disincentives for not reporting.

Between PQRS and the Value-Based Payment Modifier programs, failing to report quality measures in 2015 will result in up to a 6 percent reduction in Medicare reimbursements in 2017, Dr. Gellad said.

A second key point: The private sector is following CMS’ lead.

“Other insurers are increasingly trying to measure the quality of care gastroenterologists provide,” Dr. Gellad said. “Some rely on PQRS and some rely on their own proprietary measures. But all rely increasingly on quality improvement programs. You are seeing and will continue to see greater adoption of quality metrics outside CMS.”

A third key point: Transparency is becoming an expectation.

CMS took the lead on transparency with its Physician Compare website
(www.medicare.gov/physiciancompare/). The agency has announced that it will include physician participation in PQRS as one of its disclosure items beginning in 2016. For now, Physician Compare shows a physician’s use of electronic health records and participation in the CMS electronic prescribing incentive program.

CMS already discloses comparative hospital quality metrics on its Hospital Compare website (www.medicare.gov/hospitalcompare/). The agency also publishes physician-specific financial transparency reports under its Open Payments Program. If and when CMS begins to report physician quality metrics, private payors are likely to follow.

A fourth key point: Patients care about quality.

“I have heard of patients making inquiries about quality metrics for physicians prior to seeing them just as they do for hospitals,” Dr. Gellad said. “Not reporting quality metrics could impact patient decisions when they select a provider.”

Please refer to the schedule-at-a-glance in Monday’s issue for the time and location of this and other DDW® events.

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