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REGULATORY REVIEW


Medicare Proposes Quality Reporting Changes Prepare now for new requirements that could be coming your way in 2017 BY KARA NEWBURY


ASCs began reporting quality data to Medicare in 2012. There were five qual- ity measures, all of which could be submitted on the


claim forms that ASCs already submit to Medicare. Four years later, the number of measures in the ASC Quality Report- ing (ASCQR) Program has more than doubled, and if the seven new measures referenced in the 2017 ASC proposed payment rule that are intended for inclu- sion starting in 2018 are finalized, the number will have almost quadrupled.


Current Measures The ASC Quality Reporting Program currently has 12 measures: ■


ASC-1: Patient Burn ■ ASC-2: Patient Fall ■


ASC-3: Wrong Site/Side/Patient/ Procedure/Implant


■ ASC-4: Hospital Admission/Transfer ■


ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing


■ ASC-6: Safe Surgery Checklist Use ■


■ ■


ASC-7: ASC Facility Volume Data on Selected ASC Surgical Procedures


ASC-8: Influenza Vaccination Coverage among Healthcare Personnel


ASC-9: Endoscopy/Poly Surveillance: Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients





ASC-10: Endoscopy/Poly Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous Polyps— Avoidance of Inappropriate Use





ASC-11: Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery (Voluntary)





ASC-12: Facility Seven-Day Risk- Standardized Hospital Visit Rate after Outpatient Colonoscopy


18 ASC FOCUS SEPTEMBER 2016


epidural anesthesia lasting 60 minutes or greater are normothermic (96.8F) within 15 minutes of arrival to the post-acute care unit. CMS states that impairment of thermoregulatory control due to anesthe- sia may result in perioperative hypother- mia, which is associated with numerous adverse outcomes, including


cardiac


For more information on the cur- rent measures, including their data col- lection and reporting requirements, click on “Quality Reporting” under the “Federal Regulations” tab on ASCA’s home page, navigate to “2016 Report- ing Requirements” and click on “How to Meet Medicare’s 2016 ASC Quality Reporting Requirements.”


The one major change the Centers for Medicare & Medicaid Services (CMS) proposed to the current mea- sure set is the reporting deadline for ASC-6, ASC-7, ASC-9 and ASC-10, which are all web-based measures sub- mitted via QualityNet. CMS has pro- posed a May15 reporting deadline for these measures in 2017 and beyond, which would align the reporting dead- line with the current ASC-8 deadline.


Proposed Measures CMS proposed no new measures for inclusion in the ASCQR Program for 2017 but proposed seven new measures for inclusion beginning with 2018 data collection and one additional measure for which CMS is seeking feedback.


Normothermia The first new measure proposed for 2018 is ASC-13: Normothermia Outcome. This measure determines whether or not ASC patients receiving general, spinal or


complications, surgical site infections, impaired coagulation and colligation of drug effects, as well as post-anes- thetic shivering and thermal discom- fort. When intraoperative normother- mia is maintained, patients experience fewer adverse outcomes. ASC-13, if finalized, will be based


on aggregate measure data collected by the ASC and submitted via Quali- tyNet. The first data collection period for the proposed ASC-13 measure would be 2018. That data would then be reported in 2019 and impact 2020 payment determinations. The outcome measured in ASC-13


is the percentage of patients having surgical procedures under general or neuraxial anesthesia of 60 minutes or more in duration who are normother- mic within 15 minutes of arrival in the post-anesthesia care unit (PACU). The numerator is the number of sur- gery patients with a body temperature equal to or greater than 96.8 degrees Fahrenheit recorded within 15 min- utes of arrival in the PACU, and the denominator is all patients, regard- less of age, undergoing surgical pro- cedures under general or neuraxial anesthesia of greater than or equal to 60 minutes in duration. The mea- sure excludes: patients who did not have general or neuraxial anesthesia; patients whose length of anesthesia was less than 60 minutes; and patients with physician/advanced practice nurse/physician assistant documen-


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