Quality and Resource Use Reports
2015 marked the first year that the Center for Medicare & Medicaid Services (CMS) will distribute Quality and Resource Use Reports (QRURs) to all solo practitioners and group practices nationwide. In early September, CMS made available these QRURs, which reflect performance on quality and cost measure data collected in 2014. These reports serve as a tool to help solo practitioners and group practices better understand their performance on federal quality and cost metrics, which already impact Medicare payments for select physicians and will impact payments for all physicians starting in 2017.
QRURs are confidential feedback reports offered under CMS’ Physician Feedback Program that provide information about the resources used (cost) and the quality of care provided by physicians and group practices to Medicare fee-for-service (FFS) patients. The reports are intended to provide comparative performance data that physicians can use to improve the care provided to Medicare beneficiaries.
Some of the information in the QRURs is also used by CMS to calculate the Physician Value-Based Payment Modifier (VM). The VM, authorized under the Affordable Care Act, provides either bonus payments, payment penalties, or a neutral adjustment (no bonus or penalty) to a physician’s Medicare payments based on quality and cost performance, compared to their peers.
Note that all physicians and group practices will be subject to the VM in 2017 based on a composite score of metrics they report under the Physician Quality Reporting System (PQRS) in 2015, and multiple other quality and cost metrics that CMS automatically calculates based on claims. In 2017, eligible professionals may be subject to Medicare payment penalties as high as 4% based on quality and cost performance or for failure to satisfy PQRS reporting requirements. Because satisfactory PQRS reporting is a critical component of the VM, it is critical that all surgeons participate in the PQRS in 2015 and beyond.
View the CMS audio presentation (and accompanying slides) on how to interpret the QRUR, page by page
CMS Help Desk
For issues with obtaining EIDM account and accessing QRURs, call 888-288-8912.
For assistance with interpreting QRURs and requesting an informal review of your data, contact the QRUR Help Desk at 888-734-6433 (select option 3) or firstname.lastname@example.org.