Endocrine Insider
December 13, 2007

The voluntary Medicare Physician Quality Reporting Initiative (PQRI), which began July 1, will include additional measures for its 2008 program. The initiative, managed by the Centers for Medicare and Medicaid Services (CMS), allows providers to earn up to a 1.5 percent monetary bonus for reporting quality measures. Seventy-four measures previously released by CMS were included in this year’s program. In 2008, 119 measures will be available for quality reporting.

Of the 119 measures specified for 2008, 59 measures were included in the 2007 program; another 60 measures are new. Endocrinologists should be aware of one measure in particular that was included in 2007 but will not be part of the reporting program next year. The measure titled “Osteoporosis: Counseling for Vitamin D, Calcium Intake, and Exercise” will not be a reportable measure in 2008.

Participating providers should decide now which measures they plan to report to CMS when the 2008 reporting period begins on January 1. In order to earn the 1.5 percent bonus, providers have to report quality codes for at least 80 percent of the cases in which a quality measure can be applied. Providers should report on at least three quality measures if there are three or more measures that relate to the provider’s area of practice. For providers with less than three applicable measures, all relevant quality measures should be reported.

Due to the addition of new measures in 2008, the number of reporting opportunities for practitioners in endocrinology has also increased. A list of common measures that endocrinologists may choose to report is included below. Individual clinicians may find that additional measures are also applicable.

Applicable measures may include:

• Hemoglobin A1c poor control in Type 1 or 2 Diabetes Mellitus
• Low density lipoprotein control in Type 1 or 2 Diabetes Mellitus
• High blood pressure control in Type 1 or 2 Diabetes Mellitus
• Angiotensin Converting Enzyme Inhibitor (ACE) or Angiotensin Receptor Blocker (ARB) Therapy for Patients with Coronary Artery Disease and Diabetes and/or Left Ventricular Systolic Dysfunction (LSVD)
• Urine Screening for Microalbumin or Medical Attention for Nephropathy in Diabetes Patients
• Diabetic Foot and Ankle Care, Peripheral Neuropathy: Neurological Evaluation
• Diabetic Foot and Ankle Care, Ulcer Prevention: Evaluation of Footwear
• Dual-energy X-ray absorptiometry (DXA) measurement or pharmacologic therapy prescribed (women 65 or older)
• Management following fracture (patients 50 or older with fracture of hip, spine, or distal radius who had DXA or pharmacologic therapy prescribed)
• Communication with physician managing ongoing care following a fracture (patients 50 or older)
• Pharmacologic therapy prescribed (osteoporosis patients 50 or older)
• Patients with Osteoarthritis who have an Assessment of their Pain and Function
• Inquiry Regarding Tobacco Use
• Advising Smokers to Quit

A list of all 119 quality measures for 2008 can be found on CMS’ website at http://www.cms.hhs.gov/apps/ama/license.asp?
file=/PQRI/downloads/Measure_Specifications_061807.pdf