Only 20 Shopping Days Left…

I spent part of this past weekend holiday shopping with my wife. This is a bit out of character as I typically wait until the very last minute when the pressure is on. As the year draws to a close, many nephrology practices begin the process of planning for the coming year and reflecting on the successes and challenges faced in the current year. Unlike the rest of health care, many physician practices use the calendar year as their fiscal year. In this setting, practice managers and billing staff are particularly busy during the holiday season making the prospect of participating in PQRI at the last minute a bit daunting. But as with holiday shopping, there is still plenty of time to participate in PQRI this year.


During each of the past 2 years our company has operated a nephrology-specific, CMS qualified PQRI Registry. For those who don’t know, 2010 is the last year the financial incentive for successfully participating in PQRI is 2% of the nephrologist’s Medicare part B book of business (the PQRI incentive was also 2% in 2009). Two percent does not sound like a lot, but based on my personal informal survey of a number of our customers, that 2% represents between $5,000 and just over $10,000 per nephrologist. Medicare performs the calculation and the result will depend entirely on the individual nephrologist’s allowable part B charges for the year, but the checks from CMS are large. This is not a stocking stuffer.


How does the PQRI Registry work? The most popular option chosen by our nephrology customers last year was reporting the chronic kidney disease measures group for 30 late stage CKD patients. Essentially the nephrologist or his/her staff answers 5 clinical questions for 30 stage 4/5 CKD patients seen in the office at any point during the year. One of the major advantages offered by Registry reporting is that it provides the practice with the opportunity to report on these quality measures retrospectively. That allows the practice to complete the reporting at their convenience.


How much work is involved? Last year around this time I enrolled my wife in our PQRI Registry (she is a general internist). It took me an hour and a half to enter data for her 30 patients. I am planning on doing the same thing for her practice later this week. Granted I know my way around our application, but even if it had taken me 10 hours to enter this data, the financial return makes this one of the best investments her medical practice has made.


Next year things will change. Not only does the incentive drop to 1% but additional constraints will present some challenges for participation. In the context of a challenging reimbursement environment and with the SGR in the news almost monthly, nephrologists have very few investment options with the potential return offered by PQRI. Whether it is through our nephrology-specific PQRI Registry or a different registry, I am encouraging every nephrologist to report PQRI this year. Given the relatively small amount of time involved with PQRI reporting, you will still have plenty of time for that last minute holiday shopping.

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