Becker's ASC Review

104 ASC Quality & Accreditation 11 Things to Know About ASC Quality Reporting By Anuja Vaidya Here are 11 key notes on quality report for ASCs. 1. e Ambulatory Surgical Center Quality Reporting Program is a pay-for- reporting, quality data program, under which ASCs report quality data for standardized measures to receive the full update to their annual payment rate. CMS implemented the program in 2012. 2. ASCs that fail to report the necessary quality data will be dealt pay cuts. e centers that failed to report data by the deadlines in 2012 had their pay- ments cut by 2 percent in 2014. ose centers that failed to report in 2013 will see payment cuts this year, and so on for subsequent years. e pay cuts are not cumulative, however. 3. To avoid the pay cuts for calendar year 2016, ASCs must report the follow- ing quality measures: • ASC-1 Patient Burn • ASC-2 Patient Fall • ASC-3 Wrong Site, Wrong Side, Wrong Patient, Wrong Procedure, Wrong Implant • ASC-4 Hospital Transfer/Admission • 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 4. CMS will base the calendar year 2017 payment determinations on claims with dates of service from Jan. 1, 2015 through Dec. 31, 2015, that are re- ceived in the Medicare Claims Warehouse by April 30, 2016. 5. According to CMS' final 2015 ASC payment rule, "ASC-11: Cataracts: Im- provements in Patient's Visual Function within 90 Days Following Cataract Surgery" is a voluntary measure for the ASC Quality Reporting Program. Initially, the measure was to be implemented in 2014. However, follow- ing advocacy from the American Society of Cataract and Refractive Surgery, American Academy of Ophthalmology, Outpatient Ophthalmic Surgery So- ciety and Ambulatory Surgery Center Association, the implementation was delayed. CMS stated that it "recognizes the operational difficulties with this specific measure." In its 2015 rule, the measure was made voluntary. 6. e final deadline, as mandated by the final rule, for ASC-8: Influenza Vac- cination Coverage Among Healthcare Personnel was May 15, 2015. Facili- ties had to report vaccination data for three categories of healthcare person- nel — employees on payroll; licensed independent practitioners, including physicians, advanced practice nurses and physician assistants affiliated with the facility but not on payroll; and students, trainees, and volunteers aged 18 years or older. All healthcare personnel who physically worked in the facility for at least one day or more in the flu season from Oct. 1, 2014 to March 31, 2015 had to be counted. e quality measure also had to be reported through the National Healthcare Safety Network. 7. e Physician Quality Reporting System encourages individual eligible professionals and group practices to report quality information to Medicare. ose participating in the program may submit their clinical quality mea- sures electronically through the PQRS EHR reporting option to fulfill the CQM requirements for both PQRS and the Medicare EHR Incentive Pro- gram, which provides incentives for the adoption and meaningful use of cer- tified EHR technology. Participation in the PQRS program increased by 47 percent from 2012 to 2013, according to CMS' 2013 PQRS and Electronic Prescribing Incentive Program Experience Report. e 2013 PQRS incentive payments totaled $214 million. 8. A new piece of legislation has been introduced in the House of Represen- tatives to provide relief for ASC physicians attesting for meaningful use. e HITECH Act of 2009 incentivized Medicare providers to adopt and use EHR systems. But ASCs were not eligible for HITECH funds to develop the sys- tems. Under the system, as it stands at the moment, physicians had to attest to meaningful use of certified EHR technology in 2014 or face penalties in 2015. e Electronic Health Fairness Act would exempt ASC patient encounters from being counted toward meaningful use of EHRs until such time as a certified EHR technology product exists for the ASC setting. 9. e ASC Quality Collaboration published a report on ASC quality data. e report presented aggregated performance data for ASC facility-level quality measures collected by a number of volunteer organizations. In the first quarter of 2015, the report shows: • Patient fall rate per 1,000 ASC admissions: 0.136 • Patient burn rate per 1,000 ASC admissions: 0.019 • Hospital transfer/admission rate per 1,000 ASC admissions: 1.110 • Rate of wrong site, side, patient, procedure, implant events per 1,000 admissions: 0.03 • Percentage of ASC admissions with antibiotics ordered who received antibiotics on time: 99 percent • Percentage of eligible ASC patients with normothermia: 91 percent • Percentage of ASC cataract surgery patients with unplanned anterior vitrectomy: 0.50 percent 10. Possible new quality measures may include: • Postoperative nausea and vomiting • Toxic anterior segment syndrome • All case hospital admission within two days of discharge • All case emergency department visits within two days of discharge 11. In July, CMS released its proposed policy and payment changes rule for the 2016 calendar year Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System. It did not propose any new measures for the ASC Quality Reporting Program. n BECKER'S SPINE REVIEW E-WEEKLY subscribe today free • educational • up-to-date Visit beckersorthopedicandspine.com or call (800) 417-2035

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