As you begin the Physician Quality Reporting Initiative (PQRI) process, we strongly recommend that you take a moment to read through this roadmap. The PQRI roadmap is provided in an effort to enhance your facility and comfort level in completing the PQRI Module.
- It's highly recommended that you print out a copy of this roadmap for quick reference.
- Login to the Physician Portfolio using your ABFM ID and password.
- Follow the PQRI link in the Physician Portfolio to the Track Your Progress page and from there to the Part IV Modules page where you can choose to begin the PQRI module.
- On the PQRI start page, you will be given a unique PQRI ID that will enable you or your staff to access the module while bypassing access to your Physician Portfolio. Your PQRI ID will be operational for the remainder of your MC-FP cycle. However, as soon as your data have been successfully transmitted to the Center for Medicare and Medicaid Services (CMS) AND you have decided not to complete the quality improvement and post intervention data collection parts of the module for Part IV MC-FP credit, the ABFM will no longer retain any link to the PQRI ID for reasons related to privacy.
- If you indicate that you wish to use the PQRI module for MC-FP Part IV credit, the PQRI ID will remain operational until you successfully complete the second part of the module. You have one year to complete the module for MC-FP credit. Once it has been successfully completed, the ABFM will no longer retain any link to PQRI ID for reasons related to privacy. If you wish to use the ID beyond this time, you must retain the number. ABFM will not be able to provide your PQRI ID information after you have completed the module.
- To begin the PQRI process, read the introduction and then complete the Registry Terms and Conditions of Use page. Next, download and print out 15 or 30 copies of the PQRI Template, depending on whether you wish to receive the 1.5% PQRI bonus on your billings for the last half of 2008 or all 12 months of 2008 respectively. You may now log out of the PQRI area of the ABFM website.
- Gather data on either 15 or 30 consecutive, separate and distinct patients using the PQRI Template that you have downloaded. If you are collecting 30 consecutive, separate and distinct patients, the date of service must be between January 1, 2008 and December 31, 2008. However, if you are collecting 15 consecutive, separate and distinct patients, the date of service must be between July 1, 2008 and December 31, 2008. Not all of the patients must be Medicare beneficiaries, but your sample must include AT LEAST two (2) of these patients. You must complete a template for each consecutive patient with the diagnosis of Type 1 or Type 2 Diabetes Mellitus. Do not skip any patients seen with the diagnosis of Diabetes once you begin collecting data. If the patients are not consecutive, CMS will consider your data incomplete, and you will not receive the bonus.
- Once you have gathered data on either 15 or 30 consecutive, separate and distinct patients and you are certain that you have at least 2 Medicare Part B patients in your sample, return to the PQRI area of the ABFM website and enter the data from the PQRI Templates. You may allow your staff to do this by providing them with your PQRI ID, which allows them access to the PQRI module but not to any of the information in your Physician Portfolio
- Once you have entered data for all of your patients, you will receive a report providing feedback on your performance on each of the PQRI measures. This report will include comparisons to your peers’ performance. NOTE: If one of your staff is entering your data for you, you may want them to print out your report for you so that you may view it at a later date.
- You have now completed the reporting requirement for PQRI. The ABFM will transmit your data to CMS at the appropriate time.
*** At this point, you will be able to continue the module to satisfy your Part IV MC-FP requirement if you choose to do so. All the steps remaining are related to completing the module for Part IV MC-FP credit, and are not required if you are only performing the PQRI reporting to CMS. ***
- If you wish to continue the PQRI Module for MC-FP Part IV credit, you will be required to make sure that all MC-FP fees are current before proceeding.
- If you wish to continue the PQRI Module for MC-FP Part IV credit, choose at least one of the clinical measures as an area for improvement (although you are free to choose more).
- Choose the intervention categories (a minimum of two categories is required) that you would like to use for that measure; for example, if you choose to work on improving the performance of a lipid panel on our diabetic patients, you might choose a chart reminder as an intervention category. You must choose at least two, but may choose several intervention categories, based on your interests, your desire for particular improvements, and your individual practice situation.
- From the menu for the intervention categories that you chose, select as many interventions as you feel are necessary for your plan of improvement, again, based on your unique preferences and your particular practice setting. You will then be presented with a number of possible Intervention steps based on your choices.
- Design your Quality Improvement (QI) plan. To do this, check off the steps that you wish to take in implementing the plan. You may also customize your plan by typing in specific steps if you wish. This will allow you to design a unique plan. Your plan may be quite simple and streamlined, focusing on a single issue, or may be more "systems-based." For more information on plan design, you may consult the following web resources which explain "systems change":
- Complete and submit your QI plan. You may now log out of the PQRI area of the ABFM website. Spend at least one week implementing the plan in your practice. You will receive an email one week after you begin this process to remind you that you should submit your patient data.
- When you receive the reminder email about one week after you submitted your QI plan, you should again gather data on 10 patients and enter the data in the PQRI area of the ABFM website just as you did prior to your intervention implementation. You may wish to complete the PQRI Diabetes Module for MC-FP Part IV credit by waiting until 2009 to collect your post QI intervention data. You can then collect 15 or consecutive, separate and distinct patients to qualify for the 2009 incentive payment.
- Wait for feedback to be generated and view your performance on the indicators. If you have chosen to do so, you may compare your performance pre- and post-intervention. You can also view comparative reports. NOTE: If one of your staff is entering your data for you, you may want them to print out your report for you or you may view it at a later date. Your PQRI ID will be operational for the remainder of your MC-FP cycle. However, as soon as you successfully complete the PQRI module, the ABFM will no longer retain any link to the PQRI ID to protect your privacy. If you wish to use the ID beyond this time, you must retain the number. ABFM will not be able to provide your PQRI ID information after you have completed the PQRI module.
- Having successfully completed all phases of the PQRI, you will be given the opportunity
- This completes your Part IV requirement for your current stage within the MC-FP cycle.