athenahealth’s National Physician Network Live With New Centers for Medicare and Medicaid Services Pay-For-Performance Measures
All 119 PQRI Measures Have Been Built Directly Into athenaNet and National Client Base Workflow to Help Maximize Participation and Reimbursement Under Expanded Program
athenahealth, Inc. (Nasdaq:ATHN), a leading provider of internet-based business services to physician practices, today announced that athenaNet(r), athenahealth’s centrally-hosted, on-demand practice management and EMR services network, now incorporates all 119 new quality-of-care performance measures for the Centers for Medicare and Medicaid Services’ (CMS) expanded 2008 Physician Quality Reporting Initiative (PQRI). By building these measures directly into athenaNet’s real-time rules engine, athenaRules(tm), which is designed to enforce physician office workflow requirements, athenahealth clients across the nation will be automatically alerted to which PQRI measures apply to them, helping to maximize participation and reimbursement under the program.
On December 29, 2007, the President signed the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Extension Act), which authorized the continuation of the Physician Quality Reporting Initiative (PQRI) for 2008. The 2008 PQRI reporting period will run from January 1 through December 31 and will allow eligible medical professionals that report on certain quality-of-care measures given to Medicare patients to earn incentives of up to 1.5 percent of their total allowed charges. The 2007 PQRI reporting program had a total of 74 measures while the 2008 PQRI program consists of 119 quality measures, including 2 structural measures.
“Pay-for-performance, and to a lesser extent, pay-for-quality programs, are not a trend but a growing new reality for medical providers in this country. The inherent challenge presented by these emerging programs, like with traditional payer reimbursement, is physician practices’ ability to understand the various reporting rules associated with these programs and to build them into office workflow,” said Jonathan Bush, Chairman and CEO of athenahealth. “The overarching benefit of on-demand services delivered via a national network like athenahealth’s, is our ability to research, qualify, and update the network daily with new rules and measures. athenahealth’s virtual back-office service enables providers to participate in these performance reporting programs without the disruption of having to maintain and update their traditional software-only solutions.”
“We successfully used athenahealth’s services to participate in the 2007 PQRI reporting program and look forward to 2008. With athenahealth being a network-based company, all of our eight physician practice sites were able to leverage the various reporting requirements with minimal disruption to our daily routine since, like all of athenaNet, the PQRI measures were built directly into the office workflow,” said Mark Netherland, CFO of Virginia Cardiovascular Specialists, a leading cardiovascular specialty group based in Richmond, Virginia.
“Similar to our industry-unique rules engine which contains over 40 million payer rule permutations, we have now incorporated the latest PQRI intelligence into our network allowing medical practices to select the measures that are appropriate for their specialty and then identify claims that are eligible to be reported on for all selected measures,” explains Kim Williams, Senior Manager, Rules & Format Management for athenahealth.
As the PQRI program is subject to updates, athenahealth’s flexible on-demand national network will update various changes in the program as they happen to allow physicians to continue maximizing their participation, reimbursement and ultimately quality-of-care.
Editor’s note: This article originally appears on CNN.com, but they removed it. We will keep it on our site for archiving purposes.