It’s Not Too Late to Participate in Meaningful Use or PQRS

By: Tammie Lunceford, CPC with Warren Averett LLC


Many healthcare entities have finalized 2015 financially but there could be loose ends physicians or hospitals have not addressed. It is very difficult to stay abreast of the guidelines for Meaningful Use because they are constantly changing. Many struggled in 2014 to meet Meaningful Use Stage 2 even when the participation period was shortened to 90 days. The participation period for 2015 was originally set for 90 days. In October of 2015 flexibility options were released but it was after October 1st making it difficult to meet the last 90 day attestation period. During the last week of 2015, President Obama signed the Meaningful Use Hardship Bill which broadens to options to file for hardship. The Centers for Medicare and Medicaid Services released the instructions and the application to file a hardship last week. The deadline to file a hardship is March 15, 2016, if approved you will avoid a 3% adjustment to Medicare reimbursement in 2017. Some will be able to attest to Meaningful Use Stage 1 or Stage 2 with the flexibility rule, you should attest if you were able to update your dashboard and meet the measures.


The Physician Quality Reporting System has been in effect since 2007, first it was an incentive program but the incentive ended in 2014. This is a very important year because PQRS is a component of the value based modifier, 2015 is the look back period for 2017. If a physician is not participating in PQRS, they will incur a 2% adjustment to Medicare but also a possible 4 % adjustment to Medicare based on the value based modifier. The value based modifier weighs cost efficiency against clinical effectiveness and clinical effectiveness is measured through PQRS. Many administrators think it is too late but there is still time to contact an outside vendor to walk you through successful participation using your 2015 data. Many of the specialty organizations also have resources to assist members in successful participation. February 29, 2016 is the last day to submit CQMs for PQRS and EHR incentive program, those reporting through registry or QCDR have until March 31, 2016.


Do not delay in reviewing your options to participate in these programs, we are now seeing a combined adjustment potential close to 10 % if you cannot show success with either program. The lack of success with Meaningful Use has caused many to believe it has ended. Meaningful Use is expected to morph into the Merit Based Incentive Program in 2018, until then we must stay abreast of changes and try to participate especially if your Medicare payer mix is significant. Check with your vendor for assistance or reach out to a consultant soon.