Clinical Assessment Program (CAP) - Physician Quality Reporting Initiative (PQRI)

The AOA's Clinical Assessment Program (CAP) has again been selected by the Centers for Medicare & Medicaid Services (CMS) as one of the registries qualified by CMS for the Physician Quality Reporting Initiative (PQRI) incentive payment program.

The AOA developed the CAP for PQRI to provide physicians with an opportunity to receive enhanced payment from CMS and understand how patients are doing using evidence-based process and outcome measures.

What's New for AOA CAP-PQRI in 2010:

1. The 2010 bonus payment for participation in the CMS PQRI is 2%.
    
2. CMS has expanded the number of measure groups to 13. Greatly expanding your opportunity to participate in the program, the AOA CAP-PQRI will offer all 13:
   
   
   • Back Pain (PDF 161K)
   • Chronic Kidney Disease (PDF 160K) 
   • Community-Acquired Pneumonia (PDF 149K)
   • Coronary Artery Bypass Graft (PDF 162K)
   • Coronary Artery Disease (PDF 152K)
   • Diabetes Mellitus (PDF 161K)
   • Heart Failure (PDF 152K)
   • Hepatitis C (PDF 172K)
   • HIV/AIDS (PDF 161K)
   • Ischemic Vascular Disease (PDF 164K)
   • Perioperative Care (PDF 164K)
   • Preventive Care (PDF 159K)
   • Rheumatoid Arthritis (PDF 161K)
      
3. In order to continue to provide this valuable benefit, there is a fee to participate in CAP-PQRI this year. The fee is $199 to AOA members and $299 to non-members (DOs and MDs). Physicians who participated in the 2008 CAP-PQRI received bonuses in the range of $1,200-$3,000. The bonus payments for the 2009 PQRI will be made by CMS in the fall.
    
4. The AOA CAP PQRI has a money back guarantee. Due to rigorous data-checking programs, CAP-PQRI has been highly successful in submitting data to CMS for the bonus payment. Due to a high level of confidence in the program, the AOA will refund the $199 fee if you submit complete data but do not receive a reimbursement. (Proof of non-payment, i.e., supporting documentation from CMS, will be required for the refund.) Nationwide, more than 96% of physicians using a registry to submit data to CMS in 2008 received a bonus payment.
    
5. This year, physicians may select data from 30 unique patient charts to submit for PQRI. Two of the 30 charts must still be Medicare Fee for Service patients. Prior to 2010, physicians had to submit data based on a sequential sample of patient charts.
    
6. CMS requires all registries to conduct audits of participant data. Please make sure that you keep track of your 30 patient charts and match them with their computer generated Patient Identifier numbers. This number is the approximately 8 digit number that is automatically populated in the system when you add a new patient to the program. We suggest you keep a list in an Excel file for easy access and also record this number in the patient chart. All data during the reporting period for 2010 must be submitted by Feb. 1, 2011, to be eligible for the PQRI reimbursement payment. CMS payments for PQRI 2010 will be made in the fall of 2011.