PQRS & Measurement

NASW encourages clinical social workers who are Medicare providers to participate in the 2013 Physician Quality Reporting System (PQRS). Doing so not only increases practice revenue by .5 percent, but helps clinical social workers avoid a 1.5 percent penalty in 2015 for not using measures in 2013.

NASW has been involved in the development of several dementia quality measures through the Physician Consortium for Performance Improvement.  These measures were developed for use by Medicare providers and other health plan providers who perform services with geriatric patients.

NASW encourages clinical social workers who are Medicare providers to participate in the optional 2009 Medicare Bonus Incentive Program. Doing so not only increases practice revenue, but prepares clinical social workers to document performance measures prior to their permanent implementation within several years.

NASW strongly encourages members who work in health care settings to take the opportunity to comment on care transitions measures which are being considered for use in transitions of care during discharges of patients from inpatient settings and Emergency Departments.  The American Medical Association/Physician Consortium for Performance Improvement (AMA/PCPI) has released for public comment a Care Transitions Performance Measurement Set.

A quality reporting system for Medicare providers was established by the Tax Relief and Health Care Act of 2006 (TRHCA). The program is known as the Physician Quality Reporting Initiative (PQRI) and was first implemented during the period of July 1, 2007 through December 31, 2007. 

Since 2007, the Centers for Medicare and Medicaid Services (CMS) has been developing quality measures to improve the quality of services performed by Medicare providers.  Three quality measures were developed and approved for use by clinical social workers in 2008; and four additional quality measures have been proposed for use by clinical social workers beginning January 1, 2009.