What is a QRUR?
The Quality and Resource Use Report (QRUR) is a document from CMS that provides feedback about your practice’s resources used (cost) and quality of care provided by physicians and group practices to Medicare patients. The reports will provide comparative performance data that practices can use to help make adjustments in their practice processes, or course-correct, to help improve care or create more efficiencies in practice.
Some of the information in the annual QRUR was used by CMS to calculate the physician value-based payment modifier (VM).
Typically, mid-year QRURs are released by CMS in the spring of the following year (example: mid-year QRURs for 2016 were released in spring 2017). The final or annual QRUR is released in the fall of the following year (example: annual QRURs for 2016 will be released in fall 2017).
Information regarding how to obtain your QRUR is available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/2016-QRUR.html.
Why is the QRUR important?
The report will illustrate your performance against your peers for both quality and cost. The measures are risk-adjusted as well as standardized geographically to provide your practice more accurate results.
The report will provide you with a number of graphs that show if your performance on cost and quality was higher or lower than your peers. Seeing those measures will help you determine if you are on track to receive an upward, downward or neutral payment adjustment for the corresponding payment year.
The mid-year QRUR (available now) illustrates your cost and administrative claims performance, but does not affect your future payment adjustments.
All of this information will help your practice identify where there are opportunities to improve – like ensuring you are using validated protocols, or have been coding diagnoses to receive the best possible reimbursement level, instead of a more general code. The cost information in the QRUR will be similar to the cost metrics under the MIPS program. Reviewing your QRUR now will give you a better understanding of the measures that CMS uses to score cost.
Information from the annual QRUR will be available for patients on the Physician Compare database (https://www.medicare.gov/physiciancompare/ ) where individual physician’s performance scores will be posted. From the Physician Compare website: Performance scores are included on Physician Compare to help [patients] make informed decisions about your health care and to encourage all clinicians to improve the care they provide.
As an example of this, a urologist was measured with a 79 percent performance rating for making sure his female patients are “Getting screened for urinary incontinence.“
Let IntrinsiQ Specialty Solutions help you interpret your QRUR. For more information, email us at email@example.com or call 877-570-8721 x2.