2022 Quality Measures for Anesthesia

The 2022 FR provides details on how the Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), Alternative Payment Models (APMs) and other features of the Quality Payment Program (QPP) will operate during the 2022 performance year and beyond.

According to the ASA, CMS finalized the anesthesiology MVP for the 2023 reporting year.  In 2022, QPP participants will see some modifications to the program, including:

  • The MIPS performance threshold will be set at 75 points with an exceptional performance bonus applied to those individuals and groups scoring over 89 points. Individuals and groups receiving less than 75 points will incur a payment penalty on a sliding scale up to 9 percent in 2024, with those scoring under 18.75 points incurring an automatic -9 percent adjustment.
  • The quality and cost performance categories will be equally weighted at 30 percent of the total MIPS score.  Promoting interoperability and Improvement Activities performance categories will maintain their respective 25 percent and 15 percent weights, respectively.
  • The MIPS #44 measure (Coronary Artery Bypass Graft (CABG) – Preoperative Beta-Blocker in Patients with Isolated CABG Surgery) will be retired from the MIPS program.
  • The PSH Care Coordination improvement activity is now a “High” weighted improvement activity.  The ASA asserts that this designation will reduce group burden on reporting improvement activities by half.

Interestingly, CMS did not finalize its proposal to increase the completeness threshold to 80 percent in the MIPS Quality performance category in 2023 as previously proposed.  Instead, CMS will maintain a completeness of 70 percent for the next two years. ASA expects to update its Quality Payment Program website in the next few weeks with regulatory information and the Anesthesia Quality Institute expects to publish its 2022 QCDR measures book by mid-December as well. CMS expects to publish the 2022 MIPS measure specifications and other regulatory guidance within the next few weeks on the QPP website.

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.