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.

Medicare 10% Reduction in Reimbursement for Anesthesia has been reduced to 3%, effective 01/01/2021

The approximate 10 percent reduction in the anesthesia conversion factor (CF) scheduled to take effect on Jan 1, 2021 has been modified.  A statement published by the American Society of Anesthesiologists (ASA) provided the following take on the CAA:

The scheduled cut to the anesthesia conversion factor will be reduced to a 3% cut rather than the previously proposed 10% cut. An improvement, but still entirely inadequate for a specialty already hampered with a flawed payment rate, whose members are caring for COVID-19 patients on the frontlines of the pandemic.

According to an update released by the Centers for Medicare and Medicaid Services (CMS), the new national anesthesia CF will officially be 21.5600 for 2021 instead of the originally set anesthesia CF of 20.0547.  This translates to a 2.9 percent reduction from the 2020 anesthesia CF, which is far better than the 9.7 percent reduction that was authorized in the 2021 Medicare Physician Fee Schedule (PFS) Final Rule.  Your exact anesthesia CF will vary depending on your geographic location.  You can search for the CF in your area by going to the following CMS link: Anesthesiologists Center | CMS