BNA’s Health Care Daily Report

CMS Releases Measure Specifications For Physician Bonus Reporting Program
April 4, 2007

Specifications for 74 measures that will be included in a Medicare bonus payment program for physicians were posted April 3 by the Centers for Medicare & Medicaid Services.

"In general, the quality measures consist of a numerator and denominator that permit the calculation of the percentage of a defined patient population that receive a particular process of care or achieve a particular outcome," the document said.

The specifications are part of the Physician Quality Reporting Initiative (PQRI), a program that allows professionals filing claims under the Medicare physician fee schedule to earn a bonus payment by reporting data.

For example, in the measure for hemoglobin A1c, the instructions said that the measure is to be reported a minimum of once per reporting period by patients with a level greater than 9 percent, among other details.

The specifications were posted in advance of the beginning of the program on July 1. Providers will be able to identify measures applicable to their practices and to prepare for submission of quality data, CMS said.

The agency said that it anticipates a small number of additional specification changes, which may expand the applicability of the measures to additional eligible professionals.

The measure specifications are available at http://www.cms.hhs.gov/PQRI. Viewers should click on the measures/codes section of the page and scroll down to the Downloads section.

Source: The Bureau of National Affairs - http://www.bna.com/index.html