TEAM of Care

2014 CMS QCDR GPRO PQRS Measures

TEAM of Care’s application is currently being reviewed for acceptance as a Qualified Clinical Data Repository under the 2014 Physician Quality Reporting System (PQRS) program. TEAM of Care Solutions, LLC supports and intends to become qualified to submit ACO Measures #11 thru #33 as stated in the document: “Accountable Care Organization 2013 Program Analysis – Quality Performance Standards Narrative Measure Specifications – December 21, 2012” – www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/ACO-NarrativeMeasures-Specs.pdf including those measures to be reported via the PQRS GPRO Web based tool (http://www.cms.gov/apps/ama/license.asp?file=/pqrs/downloads/2013_PQRS_GPRO_MeasuresList_NarrativeSpecs_ReleaseNotes_12192012.zip) These include the following PQRS measures:

PQRS

ACO

GPRO

NQF

Measure Title/Name

PQRS 46 ACO 12 GPRO CARE-1 NQF 0097 Medication Reconciliation
PQRS 318 ACO 13 GPRO CARE-2 NQF 0101 Falls: Screening for Future Fall Risk
PQRS 110 ACO 14 GPRO PREV-7 NQF 0041 Preventive Care and Screening: Influenza Immunization
PQRS 111 ACO 15 GPRO PREV-8 NQF 0043 Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older
PQRS 128 ACO 16 GPRO PREV-9 NQF 0421 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up
PQRS 226 ACO 17 GPRO PREV-10 NQF 0028 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
PQRS 134 ACO 18 GPRO PREV-12 NQF 0418 Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
PQRS 113 ACO 19 GPRO PREV_6 NQF 0034 Preventive Care and Screening: Colorectal Cancer Screening
PQRS 112 ACO 20 GPRO PREV-5 NQF 0031 Preventive Care and Screening: Screening Mammography
PQRS 317 ACO 21 GPRO-PREV11 N/A Preventive Care and Screening: Screening for High Blood Pressure
PQRS 319 ACO 22 GPRO DM-13 NQF 0729 Diabetes Composite (All or Nothing Scoring): Diabetes Mellitus: Hemoglobin A1c Control (< 8%)
PQRS 319 ACO 23 GPRO DM-14 NQF 0729 Diabetes Composite (All or Nothing Scoring): Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus
PQRS 319 ACO 24 GPRO DM-15 NQF 0729 Diabetes Composite (All or Nothing Scoring): Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus
PQRS 319 ACO 25 GPRO DM-16 NQF 0729 Diabetes Composite (All or Nothing Scoring): Diabetes Mellitus: Tobacco Non-Use
PQRS 319 ACO 26 GPRO DM-17 NQF 0729 Diabetes Composite (All or Nothing Scoring): Diabetes Mellitus: Daily Aspirin or Antiplatelet Medication Use for Patients with Diabetes and Ischemic Vascular Disease
PQRS 1 ACO 27 GPRO DM-2 NQF 0059 Diabetes Mellitus: Hemoglobin A1c Poor Control .
PQRS 236 ACO 28 GPRO HTN-2 NQF 0018 Hypertension (HTN): Controlling High Blood Pressure
PQRS 241 ACO 29 GPRO IVD-1 NQF 0075 Ischemic Vascular Disease (IVD): Complete Lipid Profile and Low Density Lipoprotein (LDL-C) Control
PQRS 204 ACO 30 GPRO IVD-2 NQF 0068 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic
PQRS 8 ACO 31 GPRO HF-6 NQF 0083 Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
PQRS 197 ACO 32 GPRO CAD-2 NQF 0074 Coronary Artery Disease (CAD): Lipid Control
PQRS 118 ACO 33 GPRO CAD-7 NQF 0066 Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – Diabetes or Left Ventricular Systolic Dysfunction (LVEF< 40%)
as well as 1-non PQRS Measure: ACO 11: Percent of Primary Care Physicians who successfully qualify for an EHR Program Incentive Payment (NQF: N/A) Description: Percentage of Accountable Care Organization (ACO) primary care physicians (PCPs) who successfully qualify for either a Medicare or Medicaid Electronic Health Record (EHR) Incentive Program incentive payment Denominator: All primary care physicians (PCPs), identified by a primary care specialty code in one or more Medicare Part B claims or Part A Outpatient claims, who are participating in an Accountable Care Organization (ACOs) under the Medicare Shared Savings Program. Physicians participating in an ACO are defined as those submitting one or more Medicare Part B claims with the ACO’s identified Tax Identification Numbers (TINs) or one or more Medicare Part A outpatient claims with the ACO’s identified CMS Certification Number (CCNs) included on the claim. Numerator: Primary care physicians (PCPs) participating in an ACO and identified as included in the denominator for that ACO for this quality measure, who successfully qualify for either a Medicare or the Medicaid EHR Incentive Program incentive payment Exclusions: Entities that are not used for beneficiary assignment. Providers from Part B carrier file who did not bill any primary care services during the reporting year. Hospital based physicians, and physicians solely from FQHCs or RHCs.

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