Anesthesia MACRA Measures

MACRA Reporting via QCDR

For anesthesia practices, the easiest way to achieve MACRA compliance and participate in the CMS $500 million bonus pool is via the “Merit-based Incentive Payment System” (MIPS), and more importantly, report your cases via a “Qualified Clinical Data Repository” (QCDR).  While CMS has a few “MIPS measures” which apply to anesthesia practice, reporting through a QCDR provides your practice with many more anesthesia specific measures from which to choose.

8 MACRA Quality Measures

For example, here are 8 anesthesia specific MACRA measures you can easily collect without a major change in your providers’ current practice. You’re likely already doing these things, but are you documenting them in a way conducive to convenient CMS reporting?

ABG 5 – Safety for Vascular Access
Percentage of adults under anesthesia care in the operating room/procedure room who experience a serious injury from an attempt at securing vascular access of any type (arterial, central venous, peripheral venous) that is recognized in the operating room procedure room.

ABG 7 – Post-Op Pain Management
The percentage of patients 18 or older admitted to the PACU after an anesthetic with a maximum pain score <7/10 within 15 minutes of arrival.

ABG 14 – Corneal Abrasion
Percentage of patients having an anesthetic in the operating room/procedure room who experience any ocular surface injury requiring evaluation, follow up, or treatment prior to discharge from PACU.

ABG 21 – PreOp Eval for OSA
Percentage of patients who undergo a procedure in the operating room/procedure room that have a pre-operative assessment for Obstructive Sleep Apnea (OSA).

ABG 28 – PreOp Eval for GERD
Percentage of patients that undergo an anesthetic in the operating room/procedure room who are questioned about symptoms of Gastroesophageal Reflux Disease during their pre-anesthetic evaluation.

ABG 29 – PreOp Eval for Glaucoma
Percentage of patients that undergo an anesthetic in the operating room/procedure room who are questioned about a history of Glaucoma or elevated eye pressures during their pre-anesthetic evaluation.

ABG 30 – PreOp Eval for PONV Risk
Percentage of patients that undergo an anesthetic in the operating room/procedure room who are questioned about Post-operative Nausea and Vomiting risk factors during their pre-anesthetic evaluation.

ABG 31 – PreOp Eval for Alc/Tob
Percentage of patients that undergo an anesthetic in the operating room/procedure room who are questioned about alcohol and recreational drug use during their pre-anesthetic evaluation.

Earn a High Composite Provider Score (CPS)

Your goal is to ensure each provider in your group attains the highest CPS possible by the end of the year. An anesthesia CPS score consists of 2 components:

  • Quality (85%) – Report at least 6 measures over 90 day period on over 50% of all patients.
  • Continuous Process Improvement Activity (15%) – Attestation by each provider at the end of the year.

With the 8 measures listed above, MACRA compliance and penalty avoidance are easily achieved for almost any anesthesia practices. In fact, the bonus opportunities in 2017 will help offset compliance costs in years to come. Compliance in 2018 will certainly be tougher, as CMS will continue to use MACRA to justify lower payments to individual providers.

Selecting the Right MACRA Quality Platform

MACRA Compliance helps you avoid penalties and perhaps earn bonus money, but does it improve your Surgical Patients’ Experience? What if you could adopt a MACRA Compliance platform that keeps you MACRA Compliant AND helps you better manage your practice?

Adopt an intelligent platform that includes:

  • Operational Excellence Turn overtimes, On Time Starts, Prime Time Utilization, Staffing reports, Anesthesia Ready Times, Same Day Cancellations, Same Day Add-Ons, PreAssessment Clinic activity, Enterprise Scorecards, Facility Scorecards, and Daily Analytic Emails.
  • Anesthesia Quality – Over 40 Anesthesia quality measures, Automated Joint Commission reports, OPPE/FPPE support, Surgical Safety Checklist Rates, Handoff Protocol Usage Rates, and Individual Provider Scorecards.
  • Revenue Cycle Management Integration – Point of care charge capture and custom interfaces with your RCM partner. Goodbye, face sheets, claim tickets, courier service, and lost bills. Hello, secure accountability.

What’s the cost of Intelligent MACRA compliance?

MACRA Simple

Graphium Health offers MACRA Simple compliance with use of our iOS app for $459 per provider per year. This includes QCDR registration fees and does not require an interface with either your facility or billing company.

MACRA Plus

Operational Excellence and a more robust approach to Anesthesia Quality are included at no additional charge – except for any interface feeds.

MACRA Charge Capture

All of the above features, plus the addition of Revenue Cycle Management integration and electronic Charge Capture is a simple per case fee of $2.99/case, plus interface charges. Simply download our app in the Apple App Store, and your providers will be ready for intelligent MACRA compliance with included Anesthesia Quality Program and Operational Excellence.

We also offer a host of other services, including paper-based data collection, Full tablet-based EHR, and EHR interfacing.

What steps do I need to take?

  1. Call us to register you.
  2. Select use of our Mobile App or Paper Form.
  3. Start recording your quality data.
  4. We’ll handle the rest.

 

References:

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-BasedPrograms/MACRA-MIPS-and-APMs/MIPS-Scoring-Methodology-slide-deck.pdf

Disclaimer: MACRA Compliance is an ever-moving target. We spend our days and nights reading, listening, and discussing the details of a complex program with many bureaucratic moving parts – so that you don’t have to. Our mission is to educate our clients and provide clarity in times of confusion. Your success is our success. While we strive each day to be the technology partner of choice for your anesthesia group, we have not yet found a crystal ball. The information above is always subject to change, courtesy of CMS.