Now’s the time to prepare for 2017 quality reporting for ASCs

In 2012, the Centers for Medicare and Medicaid (CMS) proposed a new “pay-for-reporting” program called ASCQR. Under ASCQR, ambulatory surgery centers report on specific quality metrics in return for a full annual update to their annual payment rate, beginning with year 2014.

Since its implementation, the number of reporting measures have been steadily gone up from 5 in 2014 to 12 in 2017. As the measures indicate, CMS wants to track episodes such as burns, falls, performing wrong procedures or treating patients, hospital transfers, follow-up interval for colonoscopy and so on. CMS intends to continue ASCQR well into the future.

ASCs who have not been able to collect this information in 2016 will do well by preparing now to start collecting for 2017. You will have the first 8 months (Jan through August) of 2018 to report for the same. ASCs that meet program requirements would receive full payment update for year 2019; ASCs that do not participate or fail to meet these requirements may receive a two percent reduction of their payment update. For next year, first five measures (from ASC-1 to ASC-5) must be reported by applying G-codes during claim submissions. The next 6 measures (from ASC-6 to ASC-11) must be reported using online tools (QualityNet’s secure portal and NHSN, a surveillance system operated by CDC). Watch out for posting of the final rule and any changes to next year’s program.

Study the measures and identify how they relate to your workflow (for e.g.. the flu vaccination season). Create quality champions within your team who will work on capturing longterm measures such as colonoscopy interval for patients with history of adenomatous polyps – avoidance of inappropriate use. If you haven’t already, register your ASC in QualityNet’s portal and NHSN (links below). Ensure your billing team is aware of the G-codes that require to be submitted (available in the ASCQR checklist below). Work with your EHR vendor to test and check if you can easily pull up the data you would need.