Introduction
Quality Payment Program (QPP) reporting is an important aspect of anesthesia practice management. In this article, we'll explore the two main ways to report for QPP – Individual and Group – and discuss the benefits of each. We'll also provide an overview of the requirements and considerations for anesthesiologists and CRNAs to help them make informed decisions about their participation in the program.
Individual vs Group Reporting: Understanding the Options
Anesthesiologists and CRNAs can choose to report for QPP either as individuals, as part of a group, or both (which has been Graphium's recommended choice). Most are "Individually Exempt" and "Group Eligible," meaning they can choose not to report and avoid penalties or bonuses. It's essential for anesthesia providers to check their reporting requirements on the QPP website and review the MACRA Ready Manual (Section 1: Reporting Thresholds, Participation Status, and Reporting Options) for instructions on determining eligibility. By selecting "both", CMS will give each provider the higher of the 2 scores (Individual vs. Group).
Changes in Individual Eligibility
CMS reassesses individual eligibility thresholds twice a year. If a provider is "Individually Exempt" during the first review period and becomes "Eligible" during the second review period, they are not required to participate in that reporting year. However, it's important to note that CMS policies are subject to change without notice.
Benefits of Group Reporting
Many anesthesia groups choose to participate in QPP through Group Reporting for several reasons, including:
1. The potential for a positive payment adjustment, which can subsidize or cover the cost of quality program services.
2. The ability to benchmark performance data against other groups nationally through a standardized quality improvement program.
3. Compliance with The Joint Commission's requirements for quarterly quality reports and OPPE credentialing processes.
4. Utilizing collected quality data for bonus packages, marketing, and negotiations with insurance carriers.
5. The opportunity to showcase favorable QPP results on a public-facing website, though the available data has been limited so far.
The Value of QPP Group Reporting
In summary, QPP Group Reporting offers anesthesia practices the opportunity to achieve a positive payment adjustment, which can offset the cost of quality program services. This option also helps practices improve patient outcomes, enhance patient experiences, and reduce costs through the implementation of standardized quality programs.
Conclusion
Having a standardized anesthesia quality program is an essential aspect of anesthesia practice management - regardless if your group ultimately chooses to participate in QPP. It's important for providers to understand the benefits and requirements of both Individual and Group Reporting options. By participating in Group Reporting, anesthesia practices can not only comply with industry standards but also leverage the collected data for various strategic purposes, ultimately improving patient care and outcomes.
If you would like more detailed information regarding the QPP program, please visit the QPP website.