ACO’s Shared Savings to Incorporate PQRS Reporting

The federal government will incorporate into the Medicare Shared Savings Program the reporting requirements and payments of the Physician Quality Reporting System, under the proposed rule issued on March 31.

But the Centers for Medicare and Medicaid Services does not propose incorporating in Shared Savings the reporting requirements of the EHR meaningful use and electronic prescribing programs.

Under the proposed rule, participating accountable care organizations would report and submit data on behalf of eligible professionals to qualify for the Physician Quality Reporting System as a group practice, not as individuals. The government also proposes a PQRS calendar year reporting period for those participating in the Shared Savings Program.

"We plan to align the incorporated Physician Quality Reporting System requirements with the general Shared Savings Program reporting requirements, such that no extra reporting is actually required in order for eligible professionals or the ACO to earn the Physician Quality Reporting System incentive under the Shared Savings Program," according to the rule. However, failure of an ACO to meet the Shared Savings quality performance standard would equate to failure of eligible professionals to qualify for the PQRS incentive for that year.

"At this time, we are not proposing to incorporate such payments for the EHR Incentive Program or Electronic Prescribing Incentive Program under the Shared Savings Program," the proposed rule states. "Professionals in ACOs may still separately participate in those other incentive programs." However, CMS proposes to require in the Shared Savings programs measures and metrics included in the EHR incentive and e-prescribing programs.

Metrics related to successful participation in the programs include scoring the percentage of "meaningful users" and percentage of professionals that meet the eRx incentive, "as measures that are part of the quality performance standard," according to the rule. Including these measures and metrics in the Shared Savings Program does not duplicate or replace specific program measures required under the meaningful use and eRx programs; eligible professionals will still be required to meet all the requirements of the programs.

For more information, search the proposed rule for the section titled, "Incorporation of Other Reporting Requirements Related to the Physician Quality Reporting System and Electronic Health Records Technology Under Section 1848 of the Act."

--Joseph Goedert