Physician Quality Reporting System (PQRS)
The Physician Quality Reporting System (PQRS) is a quality reporting program that encourages eligible providers (EPs) and group practices (GPROs) to report information on their quality of care to the Center for Medicare and Medicaid Services (CMS). PQRS gives participating EPs and GPROs the opportunity to assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time.
EPs and GPROs report quality measures to CMS about health care services provided to Medicare beneficiaries. Quality measures are tools that help CMS assess various aspects of care such as health outcomes and patient engagement, and are associated with the ability to provide high-quality health care and relate to the goal of effective, safe, efficient, patient-centered, equitable, and timely care.
Through partnership with quality leaders across the UNC Health Care System (UNC HCS), Practice Quality & Innovation (PQI) administers annual PQRS submissions to CMS on behalf of key provider groups and entities. Continual regulatory policy research, modeling and quality measure updates are required to ensure successful submissions, and to aid UNC HCS in avoiding PQRS negative payment adjustments for unsatisfactory reporting.
In addition, PQI regularly collaborates with HCS leadership and clinical Subject Matter Experts (SMEs) to review and strategize improvement opportunities regarding the nationally benchmarked quality measure performance scores generated from PQRS submissions.
If you have questions about PQRS, contact the project manager, Jason Shropshire.