Case Study: Memorial Hospital achieves PQRS compliance and avoids a 4% Medicare reimbursement penalty with Health Catalyst

How to Avoid PQRS Penalties and Earn Potential Incentives with Accurate Submission of Quality Measures

Memorial Hospital faced the threat of up to 4% of Medicare reimbursement at risk after its new EHR vendor could not produce PQRS reporting for the 2014 submission; with more than 100 physicians and hundreds to tens of thousands of charts to review, the hospital confronted an onerous manual abstraction effort to meet CMS PQRS and Value‑Based Modifier requirements. Health Catalyst (Late‑Binding™ Data Warehouse and associated implementation services) was engaged to address the urgent reporting gap.

Health Catalyst implemented its EDW to aggregate data from the old and new EHRs, billing, survey, and inpatient systems, enabling Memorial to define cohorts, apply business rules, pull denominators/numerators, and produce preliminary metrics for submission to a certified registry. As a result, Memorial avoided the combined 4% PQRS/VM reimbursement penalty, saved several hundred thousand dollars, eliminated weeks/months of manual chart review, and uncovered data‑quality issues to drive ongoing performance improvement — all enabled by Health Catalyst.

Memorial Hospital

Dean Pearson

RN Director of Quality & Performance Improvement