Powerful changes have emerged in healthcare education and certification, compelled by shifting research, regulatory, and technological environments. The team at NetHealth is here to help you navigate, providing the tools and know-how to assist you in the collaborative design and implementation of web-based Performance Improvement (PI) CME / MOC modules that unleash the transformative power of combining technology and evidence-based measures for the betterment of health care. With the added introduction of CMS PQRI reporting, a new system for ensuring health care improvement is upon us. The flexible NetHealth Performance Improvement Platform (PIP) is a CMS-approved means for delivering exceptional individualized, practice-based education and simplifying physician reporting under PQRI.

What is PQRI?

PQRI is the acronym for the Physician Quality Reporting Initiative of the Centers for Medicare and Medicaid Services (CMS), a program that offers a 2% incentive reimbursement of all Medicare claims when data is submitted demonstrating the participation of physicians, practices, and hospitals in quality improvement activities. Such activities involve a three-step process:

1. Collect and input de-identified patient data on specific measures
2. Compare and assess outcomes in terms of evidence-based practice guidelines to establish areas for improvement, choose a plan, and adjust approaches accordingly
3. Collect and input new de-identified patient data following an agreed- upon period, to re-assess performance and make further adjustments in treatment options.

While the PQRI system is in the establishment stage, the 2% premium is available to all of those reporting, regardless of demonstrated improvement. However, it is well established that this powerful method not only delivers up-to-date, evidence-based guidelines, removing much of the difficulty of chasing constantly evolving treatment methods and best practices, it does indeed improve medical practice, raising the bar on quality health care and increasing patient satisfaction.

How Do PQRI and Performance Improvement Relate?

As a CMS approved participating PQRI registry, NetHealth offers an integrated solution for organizations seeking to incorporate the tangible benefit of Performance Improvement in CME / MOC activities with PQRI reporting. Our web-based Performance Improvement Platform (PIP) is user-friendly, scalable, and adaptable to any specialization or specific organizational need through collaborative, evidence-based design.

For Boards, Specialty Societies, Colleges, and other licensure and certification organizations:

Planning for mandated ABMS, CMSS and ABIM Part 4 Performance Improvement Maintenance of Certification requirements is underway, with deadlines set for 2010 or 2011. The addition of a PQRI component in your web-based PI CME activities will encourage participation while offering an impacting learning opportunity for your constituents.

For health care networks and organizations and other accredited CME and CNE providers:

Offering your valued stakeholders the opportunity to qualify for PQRI pay-for-reporting incentives allows them to benefit from the PI experience twofold. Scalable for use by individual physicians, group practices, and departmental PI planning, the NetHealth registry offers a service that eliminates the need to purchase costly, time-consuming and cumbersome systems to facilitate PQRI reporting.

Benefits of Combining NetHealth's Performance Improvement Platform & PQRI

• The NetHealth system ensures that all submissions are accurate and correct before filing, allowing for any adjustments, to avoid rejected measurements
• Participants are presented with CMS PQRI approved evidence-based best practices and expert experience to truly improve their practice and increase patient satisfaction
• Participants receive feedback on their performance in areas and quality measures important to the CMS agency
• The NetHealth program helps participants prepare to integrate the quality measures that will inevitably continue to be part of health care practice in the years to come. By participating in a customized PI activity that includes PQRI, users gain experience and reap the benefits of implementing suggested improvements, before CMS payments and penalties are based on measures and pay-for-performance.
• By participating in PQRI, physicians have the opportunity to contribute, not only to their own quality improvement, but also to the improvement of the health care industry as a whole by adding their experience and growth to CMS registry data.

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