More than 85,000 physicians and other eligible professionals who successfully reported quality-related data to Medicare under the 2008 Physician Quality Reporting Initiative (PQRI) received incentive payments totaling more than $92 million, the Centers for Medicare & Medicaid Services (CMS) announced today, well above the $46 million paid in 2007.

Eligible professionals from all U.S. states and territories participated in PQRI 2008.  Health practices with participating eligible professionals in Florida and Illinois received the highest payments.  In Florida, eligible professionals received a total of over $7.5 million, and in Illinois, they received over $6 million.  The average incentive amount for individual professionals is over $1,000, with the largest payment to an eligible professional totaling over $98,000.

Additional 2008 PQRI results, as well as information on how eligible professionals who participated in the 2008 PQRI can access confidential feedback reports, can be found in a CMS Fact Sheet.

More information about the PQRI program, including participation guidance and the criteria to qualify for an incentive payment is available at www.cms.hhs.gov/PQRI.

Chronic Kidney Disease is Often Missed

According to findings presented at the annual meeting of the American Society of Nephrology in San Diego and reported at upi.com, primary care physicians are failing to diagnose chronic kidney disease, especially in women.

Study leader, Dr. Maya Rao of Columbia University in New York says primary care doctors typically order a blood test called creatinine to measure kidney function, but this alone is not a particularly accurate measure of kidney function.  The serum creatinine should also be plugged into a formula that gives an estimated kidney filtration rate -- called glomerular filtration rate -- which is a much more accurate estimate of kidney function.  To read the entire article, click here.

The CKD Project offers many free resources on eGFR including:

• eGFR slide rule calculator
• GFR Tracking and Trending Tool
• How Well Are your Kidneys Working
• Multi-tasking GFR Results for CKD Detection, Tracking, Treatment and Patient Self-Management PPT.

Click here or on the tool above to access these resources.

Chronic Kidney Disease Stage 3 & 4:  Making Timely Referral to Nephrologists

Primary care physicians have the opportunity for helping to prevent or delay the progression of chronic kidney disease.

The Kidney Disease Outcomes Quality Initiative (K/DOQI) Chronic Kidney Disease (CKD) Guidelines provide a clear standard for classification and management of patients with kidney disease. Primary care physicians (PCPs) should use these guidelines to evaluate, manage, and refer their patients with evidence of kidney disease.

Referral to a nephrologist should be made for all patients with evidence of CKD, but certainly before the glomerular filtration rate (GFR) falls below 30 ml/minute (Stage 4 CKD) for nondiabetics or below 60 ml/minute (Stage 3 CKD) for diabetics.

FMQAI has resources to assist in determining GFR values for patients.  Click here for more information.  Visit the National Kidney Foundation website to access the K/DOQI Guidelines.

It's finally happened! After months of preparation, the practice is finally "up and running" on an Electronic Health Record (EHR). Office staff is settling into their new routine, the frantic search for charts is dwindling to a non-event, data is pulled into the EHR via various interfaces, providers document care while in the patient room, and coding is more efficient. Yes- operationally, the practice has changed with the introduction of the new EHR - all very positive and exciting. This scenario plays itself out with increasing frequency as practices migrate from paper to Electronic Health Records. But, is the implementation complete?

The Medicare Quality Improvement Organization

FMQAI serves as the Medicare Quality Improvement Organization and End Stage Renal Disease Network (ESRD Network 7) for Florida. With a strong reputation as a leader in facilitating change and collaboration, FMQAI implements projects and conducts case review activities to improve care across all settings, including dialysis and transplant facilities.

This material was prepared by FMQAI, the Medicare Quality Improvement Organization (QIO) for Florida, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services.  The contents presented do not necessarily reflect CMS Policy.  FL2009F73T1ABC1711535 www.fmqai.com