The Physician Quality Reporting System (PQRS) is a program under the Centers for Medicare and Medicaid Services (CMS). PQRS is designed to promote reporting of quality information by eligible professionals (EPs). EPs who do not satisfactorily report 50% performance on at least nine quality measures in three domains for the January 1, 2015 - December 31, 2015 reporting period, will be subject to a 2.0% negative payment adjustment (penalty) in their fee schedule amount in 2017.
In 2015 the STS National Database has once again been designated a Qualified Clinical Data Registry (QCDR) for PQRS reporting. A QCDR is a CMS-approved entity that collects medical and/or clinical data for the purpose of patient and disease tracking to foster improvement in the quality of care furnished to patients. The data submitted to CMS via a QCDR covers quality measures across multiple payers and is not limited to Medicare beneficiaries or limited to measures within PQRS.
As a QCDR, STS cannot report for surgeons who are already enrolled in the Group Practice Reporting Option (GPRO) or as part of an Accountable Care Organization (ACO.)
STS will report to CMS all of the following measures on behalf of individual consenting surgeons:
|PQRS 43||CABG - Use of Internal Mammary Artery ||Effective Clinical Care||2655|
|PQRS 44||CABG - Use of Preoperative Beta Blocker ||Effective Clinical Care||1060|
|PQRS 164||CABG - Prolonged Postoperative Intubation ||Effective Clinical Care||4835|
|PQRS 165||CABG - Deep Sternal Wound Infection Rate ||Effective Clinical Care||4700|
|PQRS 166||CABG - Postoperative Stroke ||Effective Clinical Care||4810|
|PQRS 167||CABG - Postoperative Renal Failure ||Effective Clinical Care||4870|
|PQRS 168||CABG - Postoperative Re-exploration ||Effective Clinical Care||4755-4775|
|PQRS 173||Preoperative Screening for Unhealthy Alcohol Use ||Community/Population Health||480|
|PQRS 226||Preoperative Tobacco Use, Screening and Cessation Intervention ||Community/Population Health||400 + 5055|
|STS 1||CABG - Prolonged postoperative length of stay ||Efficiency & Cost Reduction||310 + 315|
|STS 2||CABG - Short postoperative length of stay ||Efficiency & Cost Reduction||310 + 315|
|STS 3||CABG + Valve - Prolonged postoperative length of stay ||Efficiency & Cost Reduction||310 + 315|
|STS 4||CABG + Valve - Short postoperative length of stay ||Efficiency & Cost Reduction||310 + 315|
|STS 5||Isolated Valve - Prolonged postoperative length of stay ||Efficiency & Cost Reduction||310 + 315|
|STS 6||Isolated Valve - Short postoperative LOS ||Efficiency & Cost Reduction||310 + 315|
|STS 7||Patient centered surgical risk assessment and communication ||Person/caregiver centered experience & outcome||5170-5210 + 5230|
If you have questions, contact Donna McDonald, Senior Manager, STS National Database and Patient Safety, at dmcdonald [at] sts [dot] org or (312) 202-5842.