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Individual Measures

Background

For the 2016 Physicians Quality Reporting System (PQRS) program, there are 198 Individual Measures from which to choose. Individual Measures are based on only Medicare Part B Fee-for-Service patients seen by the Eligible Professional (EP) or Group Practice during the 2016 calendar year. To be eligible to report Individual Measures, you must have at least one Medicare Part B FFS patient or encounter in the 2016 reporting year.

Reporting Mechanisms

  • Qualified Registry
  • Claims Reporting
  • Electronic Health Records (EHR)
  • Qualified Clinical Data Registry (QCDR)

Reporting Individual Measures is easiest when providers are using a certified EHR and have access to Clinical Quality Measure (CQM) reports. NJII provides guidance and data-collection templates to any practice that needs to collect some or all of its PQRS data manually.

Reporting Individual Measures

  • Review patient diagnosis and encounter codes, which identify the eligible patient population for each PQRS Measures Group or Individual Measure.
  • Select measures that are applicable to your patient population.
  • Aim to report measures that you feel showcase a high level of quality in your practice.
  • Make sure you choose measures that you perform. Measures with a 0 percent performance rate will not satisfactorily meet PQRS requirements.

Providers should review the updated 2016 Individual Measures List and 2016 Measure-Applicability Validation (MAV) Process List to see if there are any changes or measures that need to be tracked in order to report accurately for 2016.

Benefits

  • 198 measures from which to choose (you can choose any nine measures across three domains to report)
  • Flexible measure selection
  • Alignment with CQMs
  • Group Practice Reporting Option for groups larger than two providers
  • Easier for certain specialists to report through Individual Measures method

NJII's PQRS Registry

  • NJII’s registry supports all 198 individual measures that can be reported.
  • NJII offers an easy-to-use registry portal.
  • NJII provides Measure Selection Guides that offer support based on specialty.
  • NJII’s skilled PQRS advisors help choose measures that best represent the EP or group practice.

Changes in 2016

Measures have been removed and added for the 2016 reporting year. Please review the 2016 PQRS Measures Specification Release Notes for updates and changes here.

2016 Cross-Cutting Measures

  • #1 – Diabetes: Hemoglobin A1c Poor Control
  • #46 – Medication Reconciliation Post Discharge
  • #47 – Care Plan
  • #110 – Preventive Care and Screening: Influenza Immunization
  • #111 – Pneumonia Vaccination Status for Older Adults
  • #112 – Breast Cancer Screening
  • #128 – Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
  • #130 – Documentation of Current Medications in the Medical Record
  • #131 – Pain Assessment and Follow Up
  • #134 – Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
  • #154 – Falls: Risk Assessment
  • #155 – Falls: Plan of Care
  • #182 – Functional Outcome Assessment
  • #226 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
  • #236 – Controlling High Blood Pressure
  • #317 – Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
  • #400 – One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk:
  • #402 – Tobacco Use and Help with Quitting Among Adolescents
  • #431 – Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

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