WORKING TOGETHEREnsuring meaningful reporting options in PQRS
The AAO-HNSF recently engaged in a project working collaboratively with our specialty’s certifying board, the American Board of Otolaryngology (ABOto), and on behalf of our Members and their diplomates to create relevant, meaningful reporting options that will help ensure quality care, improve patient outcomes, and ease the burden of reporting significantly.
The AAO-HNSF recently engaged in a project working collaboratively with our specialty’s certifying board, the American Board of Otolaryngology (ABOto), and on behalf of our Members and their diplomates to create relevant, meaningful reporting options that will help ensure quality care, improve patient outcomes, and ease the burden of reporting significantly. The AAO-HNSF strongly believes otolaryngologist-head and neck surgeons should be able to report on measures that are meaningful to their specialty. With this goal in mind, after identifying a gap in the current measures groups offered in the Physician Quality Reporting System (PQRS), the Academy convened a group of experts to create additional measures groups for both acute otitis externa (AOE) and adult sinusitis to be proposed for inclusion in PQRS in 2015 and beyond.
Requirements for successful reporting (and penalties for unsuccessful reporting) under PQRS have increased for eligible professionals (EPs). Beginning in 2015, EPs who do not successfully report for PQRS will be subject to a -1.5 percent payment adjustment based on the 2013 reporting period (January 1, 2013-December 31, 2013). In 2016, that payment adjustment increases to -2 percent, based on last year’s reporting period (January 1, 2014-December 31, 2014). In 2014, EPs must report on a total of nine measures across three National Quality Strategy domains for at least 50 percent of the EP’s Medicare Part B FFS patients seen during the reporting year to which the measure applies. Using the PQRSwizard® to report for PQRS via a measures group is an attractive option to physicians, as it significantly reduces the reporting burden to one measures group for only 20 applicable patients.
The Academy and relevant stakeholders agreed that inclusion of new measures groups for sinusitis and AOE would not only help address a reporting gap for otolaryngologists and offer a streamlined and less burdensome reporting option, but also help accomplish the aim of improving the quality of care provided to patients suffering from these and related conditions.
Your AAO-HNS/F in action: Convening measures stakeholders
In May 2014, with representation from the American Board of Otolaryngology, and the American Medical Association—Physician Consortium for Performance Improvement (AMA-PCPI), the AAO-HNSF convened a group of experts, including David R. Nielsen, MD, then AAO-HNSF executive vice president/CEO; James C. Denneny III, MD, current AAO-HNSF executive vice president/CEO and former coordinator, Socioeconomic Affairs; Robert H. Miller, MD, MBA, executive director, American Board of Otolaryngology; Randal S. Weber, MD, ABOto president-elect; Richard M. Rosenfeld, MD, MPH, AAO-HNSF senior consultant for Quality and Guidelines; Lisa E. Ishii, MD, MHS, AAO-HNSF coordinator, Research and Quality Improvement; Jane T. Dillon, MD, MBA, AAO-HNSF coordinator, Socioeconomic Affairs; Samantha Tierney, MPH, project manager II, Performance Improvement, American Medical Association; and AAO-HNSF staff. These stakeholders deliberated over the critical measures to include in the sinusitis and AOE measures groups, while reviewing measure specifications and relevant diagnosis, procedure, and encounter codes. After extensive discussion, this group agreed that the measures included in the two proposed measures groups are important and relevant to treating sinusitis and AOE.
New measures group options
After the expert group concluded its work to assemble and finalize the proposed measures groups, the AAO-HNSF submitted a letter to the Centers for Medicare & Medicaid Services (CMS) officially requesting inclusion of the sinusitis and AOE measures groups in the PQRS program. Additionally, the AAO-HNSF met with CMS representatives in June 2014 to further detail the collaborative process for creating the measures groups and to offer a supporting rationale for inclusion of the two new reporting options.
As a result of the collaborative efforts of the AAO-HNSF, ABOto, and AMA-PCPI, the Academy is pleased to announce that CMS has finalized both the sinusitis and AOE measures groups for inclusion in PQRS in 2015 and beyond, as detailed in the recently released Medicare Physician Fee Schedule Final Rule.
The new sinusitis measures group features six individual measures, including documentation of current medications in the medical record (PQRS #130), pain assessment and follow-up (PQRS #131), preventive care and screening for tobacco (PQRS #226), antibiotic prescribed for acute sinusitis (PQRS #331), appropriate choice of antibiotic (PQRS #332), and CT for acute sinusitis (PQRS #333).
The new AOE measures group features eight individual measures, including use of topical therapy for AOE (PQRS #91), avoidance of systemic therapy for AOE (PQRS #93), documentation of current medications in the medical record (PQRS #130), pain assessment and follow up (PQRS #131), risk assessment for falls (PQRS #154), plan of care for falls (PQRS #155), preventive care and screening for tobacco (PQRS #226), and preventive care and screening for high blood pressure (PQRS #317).
The Academy remains committed to continued partnership with ABOto in efforts to assist our Members with quality improvement initiatives, including developing and maintaining clinical quality measures, and ensuring meaningful reporting options are available in PQRS and other reporting programs. In fact, AAO-HNSF recently formed a Performance Measures Task Force to proactively address the ongoing need to develop new measures and measures groups, assume stewardship of existing measures, and pursue meaningful reporting solutions applicable to our otolaryngologist Members. The Academy is confident that the creation and inclusion of the sinusitis and AOE measures groups will be more relevant to otolaryngologists and encourage greater PQRS participation within the otolaryngology community, and we look forward to continued collaboration with other measures stakeholders such as the ABOto, AMA-PCPI, and CMS, to ensure robust participation by otolaryngologists in PQRS and other reporting programs.