Multiple Chronic Conditions Blog

Provider Accountability and Transparency, 2016

Friday, 01 January 2016 15:11 / by Dr Kim Kuebler

The federal government seeks input from the Measure Applications Partnership (MAP), a public-private partnership convened by the National Quality Forum (NQF), to provide recommendations to the Department of Health and Human Services (HHS) on the selection of performance measures for public reporting and performance based payment programs. In closing 2015 MAP examined 199 unique measures for potential use in 20 different federal health programs.

This process affords MAP the opportunity to promote alignment across HHS programs and with private sector efforts, incorporate measure use and performance information into MAP decision-making, as well as provide specific recommendations on the best use of available measures and on ways to fill gaps in measurement.

The Physician Quality Reporting System (PQRS) for eligible providers requires at least 9 measures embedded into the electronic medical record covering 3 of the National Quality Strategy Domains which have to align with Medicare incentive programs.

Eligible providers determine specific outcome-based measurements for submission to PQRS – this is used to determine the value based payment modifiers. PQRS will be used to determine provider accountability. The value-based modifier and provider feedback of resource and use reports provide data on the quality and efficiency of medical care.

Providers enrolled in the Medicare system will be noted on the Federal website that report transparent information on physicians and other providers – this public reporting of quality measures will be meaningful to patients when determining provider performance scores and outcome data.

Provider participation in quality measurement demonstrates provider commitment to improve the care for Medicare beneficiaries. Health care professionals and group practices can participate in various quality activities, including the Centers for Medicare & Medicaid Services (CMS) Quality Programs. The CMS Quality Programs are listed below. If a health care provider or group practice participates in one or more of these programs, Physician Compare includes a green check mark on the profile page. Showing a commitment to quality is the first step in achieving quality care for all Americans.

Dr Kim Kuebler

Dr Kim Kuebler

Dr. Kim Kuebler DNP, APRN, ANP-BC, Founder and Director Multiple Chronic Conditions Resource Center, CEO Advanced Disease Concepts, LLC., Award winning author of 8 textbooks on chronic conditions and palliative care. Multiple appointments to Federal and state initiatives on pain, chronic conditions and palliative care. Clinician, educator, researcher and patient advocate.