CMS Releases newest Quality Resource and Use Reports (QRUR) & Value Modifier (VM) Information

Date: September 21, 2017

The Centers for Medicare & Medicaid Services (CMS) released information on the 2016 Quality Resource and Use Reports (QRUR) as well as the Value Modifier (VM) on September 18, 2017. Your 2016 PQRS Feedback Reports are available as well.   This information is available to individual practices via your specific login to the CMS Enterprise Portal (link here to login).

The information released by CMS is important to practices as the QRUR and VM reports affect your 2018 payments.  CMS notes:

“ … The 2016 Annual QRURs show how physician, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value Modifier as well as their 2018 Value Modifier payment adjustment. Groups and solo practitioners are identified in the QRURs by their Medicare-enrolled Taxpayer Identification Number (TIN).”

CMS noted the following about the 2016 Annual QRURs:

“The 2016 Annual QRURs show how groups and solo practitioners performed on quality and cost measures relative to national benchmarks and indicate if … [providers] will receive an upward, neutral or downward Value Modifier adjustment to their payments for items and services rendered … in 2018. The QRURs also contain … information about care delivered to Medicare beneficiaries … [and so] better understand quality and cost performance …”

Corcoran Consulting Group strongly encourages practices to access the information and review it carefully.  Remember that even though the Merit-based Incentive Payment System (MIPS) is in place currently in 2017, it does not affect your payments until 2019 – you still reported PQRS in 2016 and were therefore also affected by the Value-based Payment Modifier – so your payments from Medicare in 2018 are possibly impacted.

Link here to learn how to access your 2016 QRUR report.  Importantly, by reviewing the information, if you see something you feel might be a mistake that would negatively affect the practice, you can “request an informal review of perceived errors in their 2018 VM calculation.”  CMS notes that requests can only be made during the informal review period which runs from September 18, 2017 through December 1, 2017.  To access the appeal information you can link here to the CMS “Quick Reference Guide” on the subject.

We are happy to help with this or other documentation and coding concerns.  Please contact us via one of the below or on our “App”, Corcoran 24/7 which can be accessed via one of the below links.

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