Please note that this article contains information that is only relevant to American clinics.

 

Has your clinic received a letter stating that you’re subject to a 2% payment reduction on all Medicare payments during the 2017 calendar year? Unfortunately this rule is affecting many physical, occupational, and speech therapy clinics across the country. You can learn more about why your facility is being penalized by looking at your PQRS feedback report.

 

Click here to find out how to access your 2015 PQRS feedback reports today.

 

Recently, we’ve been receiving calls from many of our American clients who are facing the 2% payment reduction penalty. They’re being penalized despite the fact that they completed the necessary reports for at least 50% of all eligible patients. However, this only speaks to the ‘reporting rate’—the payment reduction is relevant to the ‘performance rate’, as well.

 

How ‘performance rate’ works

 

According to Rick Gawenda of Gawenda Seminars and Counsulting, a clinic’s ‘performance rate’ is defined as “the percentage of times that you met the measure compared to the number of eligible patient visits entered for that measure and how many times you could have met the measure.” The CMS calculates this figure by dividing the number of patients with quality actions (i.e. met) by the number the number of patients who were eligible for the measure, minus the ones who were excluded.

 

Rick created the following formula to help you obtain your ‘performance rate’ as a percentage:

 

Met ÷ (Total Number of Eligible Patients – Excluded) X 100 = Performance Rate (in percentage)

 

If your ‘performance rate’ was ‘0’, there’s a good chance that your facility is being penalized during the 2017 calendar year. Fortunately, as of January 1, 2017, PQRS will be a thing for the past.

 

We hope that you found this article helpful in understanding the 2% payment reduction imposed by the CMS. If you’d like to access more content like this, click here to access the Gawenda Seminar and Consulting website and learn more about the benefits of becoming a Gold Member.

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