The New CMS Quality Reporting System and What a Center Needs to Do to Prepare
At the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 14, 2012, David Shapiro, MD, partner at Ambulatory Surgery Company, discussed the new federal quality reporting system and what ambulatory surgery centers can do to prepare.
Data collection for the new ASC quality reporting program will begin in CY 2012 for five measures, with payment determination beginning in CY 2014:
1. Patient burns
2. Patient falls in the ASC
3. Wrong site, wrong side, wrong patient, wrong procedure, wrong implant
4. Hospital transfer/admissions
5. Prophylactic IV antibiotic timing
ASCs that do not submit quality measure data will incur up to a 2.0 percent reduction. ASCs will be considered successful reporters and get full payment if they meet the completeness threshold of 50 percent. Dr. Shapiro predicts this threshold will increase over the next couple of years. Addition measure sets will be phased in over a three-year period, starting this October.
ASCs will be required to use different methods to report the required information, including G-codes added to claims, the web-based QualityNet and the CDC's National Healthcare Safety Network. Dr. Shapiro said ASCs should not hesitate to be in touch with the ASC Association if there are any questions or concerns regarding these various reporting methods.
Safe Surgical Checklist
The quality reporting program includes a measure that would assess whether the ASC uses a safe surgery checklist in general. There are many prototypes, though ASCs may need to tailor any checklist to the specific needs of the facility.
What can ASCs do to prepare?
ASCs should begin now to better understand the quality reporting program, including reviewing measure specifications, communicating to physicians, clinical staff and non-clinical and/or the business office. ASCs must also designate a point person to ensure compliance, map out processes for collecting and reporting data and stay current and informed.
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