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Physician Quality Reporting System

What is a Physician Quality Reporting System?

A Physician Quality Reporting System uses payment adjustments to incentivize healthcare professionals participating in Medicare to report data on their quality measures.

The quality measures cover services in the Physician Fee Schedule which are provided as part of Medicare Part B. They were developed to deal with the gaps in the quality of care Medicare patients face and cover aspects of care such as healthcare processes, organizational structures, and outcomes.

Examples of quality measures include:

  • Preventive care and screening: tobacco use
  • Diabetes: Hemoglobin A1c poor control
  • Documentation and verification of the current medications in the medical record

Participating physicians report on their quality measures to the Centers for Medicare and Medicaid Services.

Why is a Physician Quality Reporting System important to healthcare?

The physician quality reporting system is important because it helps to improve the quality of services that Medicare patients receive. The quality measures help providers to see whether they are meeting quality metrics and to compare their performance with that of their peers. It also enables the government to receive information on the quality of care provided which cannot be deduced from regular Medicare claims.