Term: PQRI- Physician Quality Reporting InitiativePQRIlogo2.gif

Description: PQRI- Physician Quality Reporting Initiative is a Tax Relief and Health Care Act signed by the President and run by the Centers for Medicare and Medicaid Services (CMS) to ensure quality of health care professionals. PQRI provides financial incentive for eligible professionals who voluntarily provide feedback for the CMS to report. All Medicare-enrolled eligible professionals may participate, regardless of whether they have signed a Medicare participation agreement to accept assignment on all claims.

Application: Although this is not mandatory the benefits enrolling into this program can save eligible professionals (EP) a significant about of money. To participate in the Physician Quality Reporting Initiative (PQRI), a physician or other eligible professional should begin by reviewing the detailed PQRI Quality Measure Specifications and related informational materials available on the CMS PQRI website. EPs should select measures applicable to their patient panels and the professional services furnished to his or her patients. The EP then should adhere to the specified quality data code on the claims under the Medicare Physician Fee Schedule (PFS) and provide that information during the reporting stage. Also, the EP must report on at least three quality measures to receive any incentives. One of those three measures being that the EP must report on 80 percent of the cases and if found that the EPs reported less than the percentage, they will have all incentives revoked from them.

Web Resources:
http://www.cms.hhs.gov/pqri/
http://www.pqri.org/about.asp

Related Terminology:
Medicare
Medicaid


Citation: Picture from http://www.pqri.org/about.asp.