Through the leadership of the American Chiropractic Association (ACA), DC eligibility to participate in Medicare’s quality reporting program has expanded. The program, known as the Physician Quality Reporting Initiative (PQRI), incorporates a total of 153 quality measures and 7 measures groups in 2009, with three measures and one measures group applicable to chiropractic. The three measures are: “pain assessment prior to initiation of patient treatment,” “adoption/use of health information technology,” and “functional outcome assessment in chiropractic care.” The one measures group on which chiropractors will be eligible to report is the “back pain measures group.”
In 2007, recognizing the importance of improving the quality of patient care in the chiropractic setting, ACA established an internal Performance Measurement Workgroup to address quality measures development, endorsement, and implementation issues specific to the care provided by doctors of chiropractic. The Workgroup was integral in the development and the inclusion of the “functional outcome assessment in chiropractic care” measure in the 2009 program.
Since July 2007, the Centers for Medicare and Medicaid Services (CMS) has sponsored a voluntary program for physicians to report codes to Medicare regarding “quality” protocols and services performed in their practices. This program is a key component of CMS’ effort to transform the Medicare program from a passive payer to an active purchaser of high-quality care by linking payment to the value of care provided. Under the 2009 quality reporting program, eligible Medicare providers who choose to participate will help capture data about the quality of care provided to Medicare beneficiaries. Participation will help identify the most effective ways to use the quality measures in routine practice, as well as support physicians in their efforts to improve quality of care. The 2009 PQRI will retain the new reporting options that were added in July 2008; doctors of chiropractic will be eligible to report quality data to CMS using either the claims based, registry based or measures group reporting options. Eligible professionals who report quality measures to CMS from January 1, 2009 through December 31, 2009 will receive a bonus payment of two percent of all their total estimated Medicare Part B allowed charges.
The detailed specifications for all final PQRI measures, along with other information on the PQRI program, can be found at www.cms.hhs.gov/pqri. Information regarding practical tips for DCs choosing to participate in the 2009 PQRI will be posted on ACA’s website in the coming weeks, located at ACA’s Medicare Quality Reporting webpage. In addition, ACA will host a teleseminar on how to participate in the 2009 PQRI on January 27, 2009.
While physicians do not need to register for this program, a National Provider Identifier (NPI) is required to participate and file claims. The NPI is a unique identification number for covered health-care providers. These providers and all health plans and health-care clearinghouses use the NPIs in the administrative and financial transactions adopted under HIPAA.
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