PQRS Submissions Automated

Under the Tax Relief and Health Care Act of 2006, CMS implemented the Physician Quality Reporting Initiative (PQRS)) with a bonus payment of 1.5 percent for successful participation based on the estimated total allowed charges for all cover services during the reporting period. Physicians and non-physician providers who participate in the program must transmit data to CMS regarding the quality measures reported on in caring for their Medicare patients.

ADL has interfaced our Physician Billing module to submit the PQRS data to CMS. The information is general and sent to PQRS Wizard developed by CECity.

CECity is the #1 cloud-based solution for PQRS Reporting. Providers reporting to CMS through CECity have realized an unparalleled payment success rate of over 99.5%! CECity’s PQRS Solution has a high level of returning users, and a growing community of eligible professionals from practices, physician groups and healthcare organizations both large and small.

Emdeon One Certification

Emdeon acquired Capario to enhance their Revenue Management Platform. The new platform is Emdeon One. ADL is certified by Emdeon to provide a seamless integration of their functions with our patient accounting software.

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ONC Roadmap Examined

The Workgroup for Electronic Data Interchange says that the Office of the National Coordinator for Health IT’s interoperability roadmap should “better reflect the realities, gaps, challenges and opportunities” of health IT. Meanwhile, the Federal Trade Commission says ONC should consider how providers’ and vendors’ economic interests align with the benefits of interoperability. FierceHealthIT et al.


Meaningful Use Program

During a Health IT Policy Committee meeting yesterday, Office of the National Coordinator for Health IT officials shared data that show about 176,000 eligible professionals have registered for the Medicaid meaningful use program, exceeding earlier projections. Officials also presented plans to broaden ONC’s certification program. Health Data Management et al.

Nursing Homes’ Progress

Significant reductions in adverse drug events, infections, wounds and use of restraints in nursing homes are among the key achievements touted this week by federal regulators. The good news comes in a progress report on the Centers for Medicare & Medicaid Services’ Quality Improvement Organization Program, a five-year effort designed to enhance the quality of services for Medicare beneficiaries.

CMS redesigned the QIO program in August 2014. More than 5,000 nursing homes were recruited to participate in the national collaborative.

Among the achievements among participating nursing homes:

  • 44,640 potential adverse drug events were prevented;
  •  3,374 pressure ulcers were prevented or healed in 787 facilities;
  •  6,250 Medicare beneficiaries in 981 facilities are now restraint free; and
  • 85,149 fewer days with urinary catheters for Medicare beneficiaries.

Two key nursing home goals in the five-year program are a resident-centered care and safety initiative, and an effort to reduce the use of antipsychotics.

Under the quality of resident-centered care and safety initiative, the QIO program hopes to unite nursing homes, key stakeholders and organizations throughout their communities to share tools, knowledge and technology to achieve system-wide improvement. One in five nursing home residents current suffer preventable harm, according to a recent Inspector General report.

The antipsychotics reduction initiative aims to reduce an original 19.8% national use of antipsychotics in long-stay nursing home residents while providing education, training and technical assistance to nursing home facilities.

For more information, download the complete report or visit the QIO website.