CMS will cancel major bundled payment initiatives
CMS has proposed canceling the cardiac and expanded joint replacement bundled payment models.
The rule, which was sent to the Office of Management and Budget last week, would cancel the mandatory bundled payment programs for heart attacks and bypass surgeries as well as expansion of the existing Comprehensive Care for Joint Replacement model to include surgical treatments for hip and femur fractures. Those bundled payment initiatives have already been delayed twice. They’re currently slated to take effect Jan. 1, 2018.
Physicians would have the opportunity to earn a 5 percent bonus for participating in the cardiac bundles or the expanded CJR model, as the initiatives qualify as Advanced Alternative Payment Models under the Medicare Access and CHIP Reauthorization Act’s Quality Payment Program. Once finalized, the CMS rule would eliminate the bonus opportunity for physicians.
CMS Releases 2017 Measure Specifications for the Merit-Based Incentive Payment System
The Centers for Medicare & Medicaid Services (CMS) released measure specifications for the 2017 transition year for the Merit-Based Incentive Payment System (MIPS). Measure specifications are available for download here. Members are encouraged to review measures applicable to their practice as they prepare to participate in quality reporting under MIPS.
The Anesthesiology Specialty-Measure Set finalized by CMS includes the following measures:
MIPS 044: Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery
MIPS 076: Prevention of Central Venous Catheter (CVC) Related Bloodstream Infections
MIPS 130: Documentation of Current Medications in the Medical Record
MIPS 317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
MIPS 404: Anesthesiology Smoking Abstinence
MIPS 424: Perioperative Temperature Management
MIPS 426: Post-Anesthetic Transfer of Care: Procedure Room to Post Anesthetic Care Unit (PACU)
MIPS 427: Post-Anesthetic Transfer of Care: Use of Checklist or Protocol for Direct Transfer of Care from Procedure Room to Intensive Care Unit (ICU)
MIPS 430: Prevention of Post-Operative Nausea and Vomiting (PONV) – Combination Therapy
The MIPS quality component accounts for 60% of the composite score in 2017. Eligible Clinicians (ECs) and groups must report a minimum of six (6) quality measures, including one (1) outcome measure or high-priority measure if an outcome measure is not available, to meet the minimum requirements for the quality component under MIPS. The ASA successfully advocated to CMS to define MIPS 424 as an outcome measure, thus increasing physician anesthesiologists’ opportunity to report outcome measures in the quality component of MIPS. High-priority measures are those defined as appropriate use, patient safety, efficiency, patient experience and care coordination measures. ECs and groups may report MIPS and/or non-MIPS measures to fulfill the quality component requirement and are encouraged to report more than the six required measures. ASA expects that ASA non-MIPS QCDR measures will be released early next year. CMS will calculate quality component scores using ECs and groups six highest performing measures. Bonus points are available for ECs and groups that report additional outcome and high-priority measures. If less than six measures are applicable to an EC or group, they must report on all applicable measures.
