The zero percent rule implemented in 2011 continues for 2016 Physician Quality Reporting. Whether reporting individual measures or a measures group, measures with a 0% performance rate (100% for inverse measures), are not considered successfully reporting.
An eligible professional reporting via registry for a measures group needs to report all of the measures in the group (where the patient is eligible for the measure) for 20 patients AND have a performance rate >0% for each applicable measure during a specified reporting period to be considered incentive eligible. Note: An inverse measure with a 100% performance rate will not be counted as satisfactorily reporting the measures group. An answer of “Not Done/Unknown” or “Performance Not Met” equivalent for all eligible patients for a given measure within the measures group will result in a performance rate of 0% for that measure and the provider will not have successfully reported.
In cases where a measure within a measures group is not applicable to a patient, the patient would not be counted in the performance denominator for that measure (e.g., Preventive Care Measures Group – Measure #39: Screening or Therapy for Osteoporosis for Women would not be applicable to male patients according to the patient sample criteria). If there are NO eligible patients for a given measure within a measures group the result would be a 0/0 or NULL performance and would be considered acceptable reporting.
Providers with specialties that do not fit within the guidelines for measures groups approved by CMS are encouraged to report using an alternative reporting method. Covisint also offers an individual measure reporting option. Refer to our webpage for more information on alternative reporting methods or contact us for additional information.