2015 PQRS Anesthesia Specific measures
Existing PY2015 PQRS Measures:
The following existing PQRS measures can be reported by EP’s via the Registry and Claims for 2015:
- #44 Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery Description: Percentage of patients aged 18 years and older undergoing isolated CABG surgery who received an IMA graft
- #76 Prevention of Central Venous Catheter (CVC)-Related Bloodstream Infections Description: Percentage of patients, regardless of age, who undergo central venous catheter (CVC) insertion for whom CVC was inserted with all elements of maximal sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound techniques followed
- #109 Osteoarthritis (OA): Function and Pain Assessment Description: Percentage of patient visits for patients aged 21 years and older with a diagnosis of osteoarthritis (OA) with assessment for function and pain
- #130 Documentation of Current Medications in the Medical Record Description: Percentage of visits for patients aged 18 years and older for which the eligible professional attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications’ name, dosage, frequency and route of administration.
- #131 Pain Assessments and Follow-Up Description: Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present.
- #193 Perioperative Temperature Management Description: Percentage of patients, regardless of age, undergoing surgical or therapeutic procedures under general or neuraxial anesthesia of 60 minutes duration or longer, except patients undergoing cardiopulmonary bypass, for whom either active warming was used intraoperatively for the purpose of maintaining normothermia, OR at least one body temperature equal to or greater than 36 degrees Centigrade (or 96.8 degrees Fahrenheit) was recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time
- #226 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Description: Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user.
- #342 Pain Brought Under Control within 48 Hours Description: Patients aged 18 and older who report being uncomfortable because of pain at the initial assessment (after admission to palliative care services) who report pain was brought to a comfortable level within 48 hours
- #358 Patient-Centered Surgical Risk Assessments and Communication Description: Percentage of patients who underwent a non-emergency surgery who had their personalized risks of postoperative complications assessed by their surgical team prior to surgery using a clinical data-based, patient-specific risk calculator and who received personal discussion of those risks with the surgeon
CMS approves NACOR as Registry for Anesthesiologists
The National Anesthesia Clinical Outcomes Registry (NACOR) has been designated by the Centers for Medicare and Medicaid Services (CMS) as a Qualified Clinical Data Registry (QCDR). A QCDR is a new mechanism to report physician performance. NACOR was among the first 40 registries to receive the QCDR designation. This designation will have significant implications for our specialty. In the next five years, CMS will phase out claims-based reporting in favor of registry-based reporting. With this change, responsibility for measure development, data collection and reporting will move from CMS to specialty society registries like AQI/NACOR. The most important aspect of the QCDR designation is that it allows ASA to select and develop its own measures. Previously, physician anesthesiologists were limited to reporting three measures to the Physician Quality Reporting System (PQRS). Now we can use more than a dozen additional anesthesia-related measures through the QCDR option to meet the evolving federal requirements. Further, we will have the ability to add additional measures in coming years, to cover subspecialty areas and related disciplines such as pain medicine and critical care. The goal is to enable every physician anesthesiologist to readily report on outcomes that matter to them and their patients.
New QCDR Registry Measures include:
- Post-anesthestic transfer of care: Use of checklist or protocol for direct transfer of care from procedure room to Intensive Care Unit (ICU)
- Post-anesthestic transfer of care measure – procedure room to post-anesthesia care unit
- Prevention of post-operative nausea and vomiting – combination therapy (adults)
- Prevention of post-operative vomiting – combination therapy (pediatrics)
- Composite anesthesia safety
- Immediate perioperative cardiac arrest rate
- Immediate perioperative mortality rate
- PACU reintubation rate
- Short-term pain management
- Composite procedural safety for central line placement
- Composite patient experience measure
The QCDR option has far-reaching implications regarding how physician anesthesiologists receive the 2014 payment bonus or incentive of 0.5 percent. It will also impact physician anesthesiologists who fail to successfully report after 2015 with payment penalties starting at 1.5 percent and increasing steadily afterwards. This new reporting vehicle will transform how physician anesthesiologists participate in PQRS. It will also significantly change how measures impacting patients, physician anesthesiologists and other providers are developed, tested and ultimately used to improve patient care and safety. More information about performance reporting and the QCDR mechanism is available at www.aqihq.org/PQRSReporting.aspx. Practices wishing to use NACOR and the QCDR mechanism to report performance in 2014 should notify Lance Mueller, director of the Anesthesia Quality Institute (AQI), at l.mueller@asahq.org or call (847) 825-5586, ext. 190.
