Initially, eligible clinicians could utilize claims-based reporting under the Centers for Medicare & Medicaid Services (CMS) qualified programs. However, over time it has become more and more difficult to successfully report using this familiar mechanism, especially with the transition to the new merit-based incentive payment program (MIPS). While some specialties, such as anesthesiology, lost the claims-based reporting option some time ago, many specialties are now being forced to find alternate reporting solutions in the form of a qualified registry (QR) or qualified clinical data registry (QCDR). And, CMS has made it clear that they intend to eliminate claims-based reporting. Every year, the available measures and reporting requirements change to subtly entice eligible clinicians into switching to a qualified clinical data registry (QCDR) for reporting or certified CMS registry.

A registry offers several benefits to support positive outcomes at the end of a program year. But, how do you know you are selecting the right registry partner? When researching registries, begin with your revenue cycle management partner; more than likely they have vetted the best solution for their clients. Additionally, the list of certified registries and qualified clinical data registries listed on the CMS site will provide not only registry names but services and pricing. Ultimately, you want to find a registry that meets the needs of your practice and specialty.

McKesson Business Performance Services (McKesson) has established a relationship with Premier, a healthcare improvement company focused on collecting and organizing healthcare data and converting it into comprehensive databases of actionable data.  As such, reporting medical practice data successfully for MIPS is a core proficiency of Premier.

Questions to consider when selecting a registry
  1. What internal workflow changes will need to occur and what changes will you have to adopt at your practice? The collection of data or how quality data codes are recorded could change with registry reporting. It’s important to understand changes to your workflow before your registry go-live.
  2. How often will you receive output reports/feedback analysis on your measures? The regular delivery of feedback reports is dependent on your registry vendor partner. The cadence of delivery can be anything from monthly to quarterly. Through our relationship with Premier, McKesson offers monthly feedback reports to track your program status.
  3. Does the registry have knowledge on provider-specific or TIN-specific potential incentives or penalties? Evaluate the difference between specialty based registries and multi-specialty registries; they both offer several good options for individuals and groups. Premier has partnerships with 25 medical specialty organizations and in the past they have been granted access to non-MIPS measures for reporting.
  4. Does the registry support individual and group reporting? This should be an easy question to answer by any registry vendor and generally it will be both. However, it’s important to understand how the vendor will collect and submit data if you decide to use group reporting.
  5. Are there cost and fees associated with using the registry or QCDR? Do you have to be a member or purchase a membership? When evaluating the fees associated with registry reporting, one important item to evaluate is the length and terms of your contract. Registries may offer a discounted price to sign, but will that fee go up in year two, three, or beyond? Know what the fees will be upfront and beyond just the first year of reporting. Begin your registry search with your revenue cycle management partner. Working with a partner, like McKesson, could help alleviate this negotiating step as McKesson has handled and negotiated the terms on behalf of our customers to secure optimal pricing.
  6. What technical modifications will need to be made to collect, submit and validate registry data? Claims based reporting has been a popular choice among healthcare professionals and revenue cycle management vendors over the years. However, claims based quality reporting has become more and more difficult to utilize. In fact, for some specialties, like Anesthesia, claims-based reporting was eliminated at the end of 2015. Therefore, registry reporting is growing in popularity. To submit electronically to a registry, a revenue cycle management system will need to provide the data in the approved file format. When making the decision to move toward registry, engage your vendor partner to better understand their preparedness. McKesson has worked with our registry partner, Premier, to push data to the registry and provide regular progress reports to our customers.
Premier, McKesson’s Registry Partner

McKesson has evaluated and worked with several registries in the market today. Ultimately, McKesson selected Premier as our registry partner. Premier not only garners a 99.5% success rate for reporting1, but spans across all the specialties McKesson works with; giving us one partner with one solution.

Additional benefits of Premier include:

  • Avoiding up to 4% in automatic Merit-based Incentive Payment System (MIPS) payment penalties.
  • Selecting measures that truly depict the performance of clinicians.
  • Alignment of provider measures crossing various care settings, creating shared goals for hospitals and providers.
  • Systematic view to quality and outcome measurement.
  • Reporting measures that span multiple specialties under a single organization.
  • Track meaningful benchmarks on provider performance.
  • Administrative access to on-demand facility and individual-level reports.
  • On-demand web-based performance measure dashboards.
  • Regular feedback reports to track performance throughout the program year.
  • Partnership with over 25 medical specialty societies including the American College of Radiology and the American Association of Nurse Anesthetists.
  • Recognized by CMS as the Largest physician quality reporting system (PQRS)/Quality Registry.2
McKesson and Premier – a winning partnership

Premier offers several services in general, but more than anything, utilizing the McKesson / Premier partnership would also offer additional benefits for our customers. These benefits could easily outweigh working independently with another registry.

  1. Technology alignment and advanced programing
    McKesson has spent months enhancing our technology solutions to directly align with the submission requirements for Premier. Teams across McKesson have logged hundreds of hours programing, testing, and validating data to prepare for the program go-live with Premier. Utilizing other vendors may result in additional fees to handle and provide the data.
  2. Direct data submission
    McKesson will be submitting data on a regular cadence to Premier. Our customers, who sign up for Premier, will get access to feedback reports that will provide a “report card” on their current status. They will know month by month how well they are doing under the quality performance category and will have the ability to rectify any missed opportunities in advance. Premier will not submit data to CMS without customer approval.
  3. Single partner solution
    What if you’re a group with multiple specialties? For example, an anesthesiology group with pain management? Anesthesiology has one set of measures and pain management has another unique set of measures. If this group looked at specialty-based registries they would be working with multiple registry partners, whereas Premier can handle both.
  4. Pricing and contracts
    McKesson has negotiated on behalf of our customers a competitive pricing model for registry reporting that spans multiple years. Through the partnership, you wouldn’t have to worry about hidden fees, lengthy contracts, and outside invoices.
  5. Staff
    By using Premier you would keep the same knowledgeable and familiar staff at McKesson. McKesson would serve as tier one support for Premier-related questions.

Moving to a registry can be a big step for any practice. The more information you’re equipped with will not only help you make the right decision but prepare the group for a smooth transition from claims-based to registry reporting.

McKesson Business Performance Services can help you improve profitability with revenue cycle management services designed to help hospitals and physicians maintain their focus on patient care.

Merit-based Incentive Payment System (MIPS) Final Rule

1CeCity: Performance Improvement and Lifelong learning – PQRSwizard. (6 February 2017). Retrieved from http://info.cecity.com/solutions_pqriwizard.html (CeCity was purchased by Premier)
2According to the most recent public announcement from CMS, Premier is the Largest PQRS Registry: United States. Department of Health and Human Services. Centers for Medicare and Medicaid Services. 2014 Reporting Experience Including Trends (2007-2015) Physician Quality Reporting System. CMS, 15 Apr. 2016. Web. 7 June 2016.

Selena Hood

About the author

Selena Hood, MS is Quality Measure and Reporting Program Manager of Business Performance Services.