Care Management
Care management refers to a set of evidence-based, integrated clinical care activities that are tailored to the individual patient. This ensures that each patient receives his or her own coordinated plan of care and services. Care management activities include optimizing the flow in the practice, identifying and addressing each patient’s health needs, and conducting periodic reviews of these activities. 

Care management is an evolving process. Quality Insights’ RN project coordinators assist participating practices in evaluating their current processes and systems in order to improve upon their efficiencies. Electronic health records (EHR) can facilitate the redesign of clinical practices to improve the quality of care.

Every health care system should be safe, effective, patient-centered, timely, efficient, and equitable. Active care management practices refine care delivery systems to make sure patients get the right care at the right time.

Visit our online Resource Center to view and download our care management tools.

 

Earn free CNEs download the Meaningful Use of Health Care Data independent study

Physician Quality Reporting Initiative (PQRI) The 2006 Tax Relief and Health Care Act required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals who satisfactorily report data on quality measures for covered services furnished to Medicare beneficiaries during the second half of 2007. The Centers for Medicare & Medicaid Services (CMS) named this program the Physician Quality Reporting Initiative (PQRI).

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period (January 1, 2009 - December 31, 2009) will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule covered professional services furnished during that same period (the 2009 calendar year).

Visit CMS’ PQRI Overview page to view upcoming national provider conference calls, measures codes and educational resources to help your practice participate in PQRI and start earning incentive payments. 

CMS also offers a section of its Web site about the American Recovery and Reinvestment Act of 2009.