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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Pay for Performance in Chronic Liver Disease.

Yamini Natarajan1, Fasiha Kanwal1

  • 1Department of Gastroenterology, Baylor College of Medicine, Houston, Texas.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|July 13, 2015
PubMed
Summary
This summary is machine-generated.

The Physician Quality Reporting System (PQRS) now penalizes healthcare professionals for non-compliance. Gastroenterologists must understand PQRS measures for hepatitis C virus infection to avoid reimbursement issues.

Keywords:
Chronic Liver DiseasePay for PerformanceQuality

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Area of Science:

  • Healthcare policy
  • Gastroenterology
  • Public health

Background:

  • Pay-for-performance programs are now standard in US healthcare, driven by the Affordable Care Act.
  • The Physician Quality Reporting Initiative (PQRI), established in 2007, evolved into the permanent Physician Quality Reporting System (PQRS) in 2011.
  • PQRS has shifted from a reward-based system to a penalty-based program for healthcare professionals.

Purpose of the Study:

  • To inform gastroenterologists about current Physician Quality Reporting System (PQRS) measures relevant to chronic liver disease, particularly hepatitis C virus infection.
  • To detail the submission process for PQRS measures.
  • To highlight challenges associated with PQRS measure submission.

Main Methods:

  • Review of current Physician Quality Reporting System (PQRS) measures related to chronic liver disease.
  • Analysis of submission rates for these measures.
  • Description of the PQRS submission process and identified challenges.

Main Results:

  • The Physician Quality Reporting System (PQRS) includes specific measures targeting hepatitis C virus infection.
  • Understanding and adherence to these measures are crucial for avoiding penalties.
  • The review outlines submission processes and associated difficulties.

Conclusions:

  • Gastroenterologists must be aware of the evolving Physician Quality Reporting System (PQRS) measures, especially those concerning hepatitis C virus.
  • Proper understanding of PQRS requirements and submission procedures is essential for maintaining reimbursement.
  • Proactive engagement with PQRS is necessary to navigate potential financial and administrative challenges.