• Current Issue
• ACP Hospitalist Weekly
• Supplements
• Blog
• Archives
  • By Topic
• Career Connection
• Subscribe
• RSS Feeds

Quality Corner

Measure of the month: Stroke and stroke rehabilitation

From the February ACP Hospitalist, copyright © 2009 by the American College of Physicians

By Lisa Kirkland, FACP

In accordance with a law passed by Congress late in 2006, physicians and other eligible professionals are able to receive bonus payments of a percentage (increased to 2%) of their total allowed Medicare charges, subject to a cap, by submitting information for defined quality measures. Many of these measures were developed by the AMA-convened Physician Consortium for Performance Improvement®, in collaboration with the National Committee for Quality Assurance (NCQA) and/or a medical specialty society.

In July 2008, CMS reported $36 million in bonus payments to many of the more than 56,700 health professionals who correctly reported quality information to Medicare under the 2007 Physician Quality Reporting Initiative (PQRI). The average incentive amount for individual professionals was over $600 and average incentive payment for a physician group practice was over $4,700, with the largest payment to a physician group practice totaling over $205,700.

Hospitalists have the following quality measures available to them for the 2009 PQRI and can choose up to three measures per reporting period:

• ACE inhibitor, ARB in heart failure,
• antiplatelets in CAD,
• beta-blocker in CAD with prior MI,
• DVT prophylaxis in stroke,
• antiplatelets in stroke,
• anticoagulant in stroke with atrial fibrillation,
• tPA considered in stroke,
• dysphagia screen in stroke,
• rehab considered in stroke,
• advance care plan,
• VAP prevention (head elevation),
• and CRBSI prevention (CVC insertion protocol).

The 2008 reporting period ended Dec. 31, 2008. The program will continue in 2009.

For a specific measure, the eligible (“denominator”) patient population is identified by both ICD-9 diagnosis codes and CPT evaluation/management (E/M) service codes. If a patient falls into that denominator population, the appropriate CPT-II code(s) and modifiers for the individual patient (“numerator”) are required for submission. A modifier is required if a patient is in the eligible population but does not receive the measure; the explanation must be documented in the chart as a medical, patient, system, or unspecified reason.

Measure #34: Tissue plasminogen activator considered

Dr. Kirkland is a hospitalist at the Mayo Clinic in Rochester, Minn., and a critical care specialist at Abbott Northwestern Hospital in Minneapolis. She is a member of ACP Hospitalist’s editorial advisory board.

Top

Share

 

Hospitalist Archives
Quick Links

ACP Hospitalist Weekly

From the February 1, 2012 edition

• Hospitalist practice models have little effect on job satisfaction, burnout, survey finds
• Hospital stays involving C. diff leveled off between 2008 and 2009

View issue

Cartoon Caption Contest

ACP HospitalistWeekly wants readers to create captions for this cartoon and help choose the winner. Pen the winning caption and win a $50 gift certificate good toward any ACP product, program or service.

• Name
• Email
• Caption No HTML tags permitted.

Prepare with the Experts: Live Recert Prep Courses from ACP

ACP Launches Depression Care Guide

© ACP Hospitalist and American College of Physicians

ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated