Are you leaving money on the table?
In a speech at the University of Iowa, President Obama said, “…my health care proposal will ask hospitals and providers to collect, track, and publicly report measures of health care quality. We'll provide the public with information about preventable medical errors, nurse-to-patient ratios, and hospital-acquired infections. We'll also start measuring what's effective and what's not when it comes to different drugs and procedures, so that patients can finally start making informed choices about the care that's best for them. And instead of rewarding providers and physicians only by the sheer quantity of services and procedures they prescribe, we'll start rewarding them for the quality of the outcomes for their patients.”
One mechanism for the measurement of quality care has actually already been established under the Bush administration when Congress passed the 2006 Tax Relief and Health Care Act (TRHCA).
It is time for the chiropractic profession to take the initiative and participate in these programs, before the time has passed and we are on the outside looking in. For the future of our career, our profession and our patients, I am urging you to participate in the Physician Quality Reporting Initiative(PQRI).
The PQRI was first established in 2006. This voluntary program is open to all providers possessing an NPI number.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010.
Providers who are eligible and who meet the criteria for submission of the quality measures data for the services they furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an additional payment of 2.0 percent of their total allowed charges for covered services (spinal manipulation) furnished during the 2009 calendar year.
Claims with the required participation codes must reach the National Health Claims History (NCH) files no later than February 28, 2010.
The Categories of Codes included in the PQRI are as follows:
Pain Assessment Prior to Initiation of Patient Therapy and Follow-Up
Percentage of patients aged 18 years and older with documentation of a pain assessment (if pain is present, including location, intensity and description) through discussion with the patient including the use of a standardized tool on each initial evaluation prior to initiation of therapy AND documentation of a follow-up plan
Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)
Documents whether provider has adopted and is using health information technology. To qualify, the provider must have adopted and be using a certified/qualified EHR
Functional Outcomes Assessment in Chiropractic Care
Percentage of patients 18 and older with documentation of a current functional outcome assessment using a standardized tool AND documentation of a care plan based on identified functional outcomes deficiencies.
Check with your state association or the ACA for instructions on how to file the claims.