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Everybody wants affordable, quality Medicare.

We’ve seen great valor from the Centers for Medicare & Medicaid Services (CMS) in the fight to improve the quality of Medicare.

One of the ways they have been instrumental is by utilizing the Physician Feedback Program to provide Quality and Resource Use Reports (QRURs) to physicians.

Physician Feedback Program

The Physician Feedback Program has been very instrumental in aiding the efforts of CMS by providing meaningful information.

It also rewires the physician reimbursement process to make it focus more on quality of service rather than quantity.

Added to that, it considers two things:

  • Quality and Resource Use Reports (QRURs) for physicians.
  • A Value-Based Payment Modifier

QRURs are really the back backbone of the whole operation. That’s where the focus will be for the remainder of this post.

Quality and Resource Use Reports (QRURs)

QRUR is a comprehensive compilation of information that allows physicians to compare the clinical care they serve to their patients versus the care and costs of other physicians’ Medicare patients.

The great thing about QRURs is that they are confidential.

Here’s what are included on the report:

  • Only portions of the patients who were able to get clinical services
  • An outline of how patients have used the various services offered
  • A comparison of what their patients spend on Medicare vs the average Medicare spending of other physicians in the region/country

The useful information in QRURs comes from various sources like:

  • Focus groups
  • Collaboration with stakeholders
  • Collaboration with physician groups, as well as specialty groups
  • Public listening sessions with healthcare providers

Etc.

For CMS, QRURs are a vital means for making well informed performance comparisons by examination of:

  • quality of care being delivered
  • types of services offered
  • associated cost of each service

More than that, QRURs help share these comparisons with physicians so that CMS can receive valuable input prior to making any change in Medicare payment based on the value-based payment modifier.

How does QRURs benefit your practice?

That’s simple. Here are some of those benefits to physicians:

  • Ability to identify their practice’s strengths and weaknesses.
  • Ability to compare the quality and cost of care their Medicare patients receive against the average cost and care of other physicians in the same geographical area.
  • Ability to make suggestions of the types of information, about their Medicare fee-for-service patients, they want to see in future QRURs.
  • Ability to categorize patients by degree of involvement.

What about the long run?

According to CMS the hope is that, in the future, QRURs will be able to display quality of care and cost data that will comprise the Value-Based Payment Modifier.

Through this, they hope to be able to inform physicians of the level of impact the Value-Based Payment Modifier will have on their Medicare payment.

 

If you are a physician, whether in a group or riding solo, you can obtain the latest (2013) QRUR from visiting the CMS website.

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