In 2010, private-practice audiologists and speech-language pathologists who are enrolled as a Medicare providers will be able to participate in the Medicare Physician Quality Reporting Initiative (PQRI) program.
PQRI is a voluntary program designed to improve the quality of care to Medicare beneficiaries. Private-practice health care professionals who participate in PQRI by reporting on approved quality measures are eligible for a 2% incentive payment. The final 2010 Medicare Physician Fee Schedule contains three audiology measures and eight speech-language pathology measures.
The three audiology PQRI measures are the result of research and advocacy efforts by ASHA and the Audiology Quality Consortium (AQC), a coalition of 10 audiology organizations.
Audiologists will be able to report on three quality measures that call for referral of patients of any age to a physician after an audiological evaluation finds one of three conditions:
- Congenital or traumatic deformity of the ear
- A history of active drainage from the ear within the previous 90 days (for patients who have disease of the ear and mastoid processes)
- A history of sudden or rapidly progressive hearing loss.
Audiology measures are reportable via claims. The AQC will develop educational materials on PQRI and how to report on these measures. Further information on the audiology measures and the AQC audiology organizations is available at Audiology PQRI.
Speech-Language Pathology Measures
The eight PQRI measures for speech-language pathology are outcome measures (function is measured before and after services are delivered). Eight of ASHA’s functional communication measures (FCM) were approved as PRQI measures in large part because these measures have been validated and used for more than 10 years through ASHA’s National Outcome Measurement System (NOMS). The speech-language pathology measures are among the first approved PQRI measures that report outcomes as opposed to process measures, which indicate only that a procedure was or was not implemented but not how it affected the patient’s health and functional status.
In 2010, private-practice SLPs may report outcomes in eight functional domains that compare the number of Medicare Part B patients aged 16 and older with a diagnosis of cerebrovascular disease (stroke) being treated by the provider to the number who make progress on one or more FCMs: spoken language comprehension, reading, spoken language expression, writing, motor speech, swallowing, attention, and memory.
The speech-language pathology measures will be reportable only through registries approved by the Centers for Medicare and Medicaid Services (CMS); ASHA has applied for the inclusion of NOMS on the list of approved registries.
Further information on these measures and on how members can participate in NOMS is available at ASHA's Web site. CMS also has information on PQRI (click on "Educational Resources" and "Measure Codes").