Pathologists Quality Registry FAQs

The College of American Pathologists’ (CAP) Pathologists has invested in resources and experts in the field who work to anticipate what pathologists require to succeed in the Merit-based Incentive Payment System (MIPS). Together, we help pathologists get paid equitably for their services through advocacy, development of quality measures that optimize scores, and platforms that ease compliance. Here are some of the frequently asked questions and answers to enrolling in the pathologists quality registry.

General Questions

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The Pathologists Quality Registry is the CAP’s MIPS reporting solution developed by pathologists, for pathologists. The CAP’s MIPS reporting registry provides pathologists with a MIPS reporting solution for the two categories of MIPS that are applicable to pathologists: Quality Measures and Improvement Activities. The pathologist-developed, CMS-approved quality measures in the CAP’s registry help pathologists maximize their scoring potential in the MIPS program. The CAP’s registry also provides tools and resources to help pathologists select and report on Improvement Activities.

The Pathologists Quality Registry is available to pathologists for use in collecting medical and/or clinical data to foster improvement in the quality of care provided to patients in addition to MIPS reporting. Designed specifically for the practice of pathology by pathologists, the registry will ensure pathologists have a mechanism for quality improvement against the CAP’s established standards, optimal opportunity for positive payment adjustments under MIPS, and compliance with requirements under the Medicare QPP program.

The CAP has partnered in the development of the Pathologists Quality Registry with FIGmd (now MRO), a company that specializes in developing clinical registries and integrating data from multiple sources into those registries.

Pathologists should use the CAP’s MIPS reporting registry to maximize their scores in the MIPS program.  There are a variety of data submission and reporting options available to pathologists and pathology practices. The Pathologists Quality Registry can help improve practice performance and identify opportunities to further enhance care with quarterly benchmarking reports against other pathology practices.

The Pathologists Quality Registry is a CMS-approved, qualified clinical data registry (QCDR). The Pathologists Quality Registry has successfully completed a qualification process that collects medical and/or clinical data for the purpose of patient and disease tracking to foster improvement in the quality of care provided to patients.

With the CMS QCDR designation, the Pathologists Quality Registry can help by submitting your Medicare data to the CMS in order to comply the CMS latest Medicare payment program QPP.

The cost for the Pathologists Quality Registry can be discussed with the CAP Registry team. The costs of the registry are less for CAP members than non-members.

The Pathologists Quality Registry includes dashboards that provide you with access to everything from performance measurements and comparisons to basic analytics. Interactive tools increase usability and flexibility and put pertinent and actionable metrics at your fingertips. You can generate reports and measure your performance results against the registry as a whole. If your practice has multiple locations, you can benchmark each location separately.

The federal government has increased reporting requirements for physicians as part of their move toward value-based payment. The rules and requirements for reporting to the MIPS program are very complex and nuanced. The CAP created the Pathologists Qualtiy Registry to help ensure that pathologists can maximize their score in MIPS and not leave money on the table with the federal government. In a time of flat or reduced professional fee schedule payments, effective participation in the MIPS program should be part of pathology practices’ financial strategy. The CAP helps practices maximize this strategy.

The CAP is the only pathologists’ medical specialty society to offer the only the CMS approved Pathologists Quality Registry on the market designed by pathologists for pathologists. The CAP creates CMS-approved measures to help pathologists score as high as possible, and CAP has the expertise and track record, the relationships with the CMS to help pathologists comply with the incredibly burdensome MIPS quality reporting requirements. In addition, the CAP regularly advocates with Congress and CMS to reduce the burden of MIPS reporting.

Interested practices should note that enrollment at the lowest enrollment fee includes membership application or renewal be completed prior to enrollment. must be completed by the dates noted above for each data submission type.

Prior to enrollment, practices should:

  1. Check their CMS QPP Account and generate a list of all members of your practice with their MIPS eligibility status.
  2. Use the list of members to and note CAP membership status. If any pathologists need to become a member or renew membership, please complete this prior to enrollment so that the practice can take advantage of the lowest rates. Non-members may join the CAP prior to the Pathologists Quality Registry enrollment process to qualify for the discounted CAP member rate. Discounted group practice membership rates are available. Join the CAP as a group and strengthen your practice, evolve your team's skills, and support the future of pathology. Learn more about CAP member benefits.
  3. Complete the Registry Inquiry Form. Once received, the CAP's registry staff will schedule a pre-enrollment call to learn more about your practice and determine which data collection method is best and discuss registry fees.
  4. During enrollment, you will be required to e-sign legal agreements (Business Associate, Participation, and Data Warehouse Agreements) and pay the annual enrollment fees.

If you have question about using the Pathologists Quality Registry, email registry.inquiries@cap.org.

Data Security and Privacy Questions

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Only authorized practice managers will have access to practice level data that includes individual pathologist dashboards. Pathologists can only see their own identifiable individual information. Data collected from other registry participants will be rolled up into the aggregate and appear as the registry benchmark.

The data submitted by practices is only used for reporting to the CMS on behalf of the practice. The CAP will not analyze, report, or sell patient or provider identifiable data. The individual patient data submitted by a practice remain the exclusive property of the practice.

Registered users are welcome to use their data to help improve and promote their practice. Data can’t be shared across practices except at the aggregate level for benchmarking purposes.

Physician access is restricted to their own individual identifiable data. Authorized practice managers can view data for any of the individual pathologists in the practice as well as the practice level.