QUALITY REPORTING UPDATE 2019

It’s time to look ahead to the data that will be reported for the Centers for Medicare & Medicaid Services (CMS) ASCQR Program in 2019 for 2020 payment determinations. 

ASC-8: Influenza Vaccination Coverage among Healthcare Personnel data collection will take place for the influenza season between October 1, 2018, and March 31, 2019, with a reporting deadline of May 15, 2019. To report ASC-8 through the National Healthcare Safety Network (NHSN) as required, someone from your ASC must be registered with NHSN.

There are 10 measures eligible Medicare- certified facilities must report to avoid Medicare payment reductions in 2020. ASCs that have fewer than 240 Medicare claims—primary plus secondary payer—per year during a reporting period for a payment determination year are not required to participate in the ASCQR Program for the subsequent reporting period for that subsequent payment determination year. This includes all program requirements, both claims-based measures and measures entered via a web-based tool.

Claims-Based Measures

ASCs must continue to report on measures:

  1. ASC-1: Patient Burns
  2. ASC-2: Patient Fall
  3. ASC-3: Wrong Site/Side/ Patient/Procedure/Implant 
  4. ASC- 4: Hospital Admission/Transfer

These claims-based measures are entered as G-codes on the CMS-1500 claim form.  

Web-Based Measures

ASC-9: Endoscopy/Polyp Surveillance: Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients and ASC-10: Endoscopy/ Polyp Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous Polyps – Avoidance of InappropriateUse are web-based measures that are reported via QualityNet. This aggregate data must be reported by all Medicare- certified ASCs, regardless of specialty or case mix. If your center does not perform colonoscopies, for both ASC-9 and ASC-10 you will enter “0” in the numerator and the denominator.

New Web-Based Measures (Data collected in 2018 for reporting beginning in 2019

ASC-13: Normothermia is used to assess the percentage of patients having surgical procedures under general or neuraxial anesthesia of 60 minutes or more in duration who are normothermic within 15 minutes of arrival in the post-anesthesia care unit (PACU). CMS has added some tools to help ASCs with this measure. 

Link to tools: https://www.qualityreportingcenter.com/asc/resources/

ASC-14: Unplanned Anterior Vitrectomy is used to assess the percentage of cataract surgery patients who have an unplanned anterior vitrectomy. It is a straight-forward measure: the numerator is the total number of patients who had an unplanned anterior vitrectomy, and the denominator is all cataract surgery patients. There are no exclusions for this measure.