Physician Quality Reporting System (PQRS) is a pay-for-reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs). A Qualified Clinical Data Registry (QCDR) is one of the reporting mechanisms available within PQRS. The collection and submission of PQRS quality measures data on behalf of EPs are the functions a traditional “qualified registry” currently performs under PQRS for purposes of EPs satisfactorily reporting. CMS believes that a QCDR should serve additional roles that foster quality improvement in addition to the collection and submission of quality measures data. For 2014, a QCDR is defined for purposes under PQRS as a CMS-approved entity that has self-nominated and successfully completed a qualification process that collects medical and/or clinical data for the purpose of patient and disease tracking to foster improvement in the quality of care provided to patients. EPs who satisfactorily participate in PQRS through a QCDR may earn the 2014 incentive payment (0.5%) and avoid the 2016 payment adjustment (2.0%).
A QCDR must perform the following functions:
Submit quality measures data or results to CMS for purposes of demonstrating that, for a reporting period, its EPs have satisfactorily participated in PQRS. A QCDR must have in place mechanisms for the transparency of data elements and specifications, risk models, and measures.
Submit to CMS, for the purposes of demonstrating satisfactory participation, quality measures data on multiple payers, not just Medicare Patients
Provide timely performance reports to participants at the individual participant level. A QCDR must provide timely feedback at least four times per year on the measures for which the QCDR would report on the individual EPs behalf for purposes of the EP meeting the criteria for satisfactory participation under PQRS.