Healthcare IT team, San Luis Obispo, Fresno By Nathan Stott, Practice Director

QRUR Basics

Do you know what your practice’s QRUR standing is? Is your practice familiar with the term? If you answered ‘no’ to both of these questions, that’s okay, you’ve come to the right place.

In this article, I will cover the basics of what practices who bill Medicare Part B need to know about QRUR, EMR optimization, and MIPS-readiness for the upcoming reporting year.

The acronym stands for Quality and Resource Use Reports, and measures how an individual provider or medical practice performed in regards to their quality of care and their effective use of resources. This is all part of CMS’s efforts to reward physicians on quality vs. quantity.

While the calculations may seem convoluted and confusing, it’s important for practices to know what their current QRUR standing is to make the proper adjustments for future payment years. This will be your foundation for what will make up your practice’s cost category of your MIPS score.

So what does that mean? What should practices be doing now?

A QRUR score is made up of how a practice scored in relation to other practices on their PQRS reporting, as well as how efficiently they used their resources. Medicare payments are shifting from a volume based methodology and now focusing on quality and value. Physician groups need to be focusing on what PQRS measures they are selecting and devising methods of how to score as high as possible within those measures. Fortunately, for the year 2017 under the MIPS program, cost is not a factor. But looking at their QRUR score for 2016 will allow practices to see where they fall and see whether or not they need to make adjustments.

Whether you are working with a consultant, your IT firm, your EMR vendor, or utilizing internal resources, your focus needs to be on identifying the right quality measure for your practice. Once those have been identified, practices should be making necessary changes to their EMR software to optimize performance on those measures.

Regardless of what your QRUR score is now, practices have a chance to reassert themselves at the front of the pack through effective selection and implementation of quality measures for 2017.

About Nathan // After earning a degree in Business Administration from Rutgers University, Nathan has been exclusively providing consulting services within the IT and Healthcare industry. As our Practice Director, Nathan develops all of our Health IT strategies and oversees our clients’ continued success by ensuring ongoing regulatory compliance, EHR optimization, and clinical workflow efficiencies.