Quality-Reimbursement

​The AANA continues to develop informational sources to aid certified registered nurse anesthetists (CRNAs) in understanding the complex relationship between quality and value outlined in many of the Center for Medicare and Medicaid Services (CMS) quality initiatives. As these quality initiatives will affect reimbursement, it is important for CRNAs to build their knowledge base and become more familiar with some of these programs. This website is intended to be an educational guide to the programs the AANA believes will impact CRNAs the most.

Announcements

10/13/2017 | Physician Compare 30-day Preview Period Begins October 18, 2017

Beginning October 18, 2017, CRNAs have the opportunity to preview their 2016 performance information before it is publicly reported on Physician Compare later this year. CRNAs may access their secured preview through the Provider Quality Information Portal (PQIP) . An active EIDM system account is required.  Data available for preview includes 2016 Physician Quality Reporting System (PQRS) measures; 2016 Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS measures; 2016 non-PQRS Qualified Clinical Data Registries (QCDR) measures; and 2015 clinician utilization data. The preview period ends on November 17, 2017 at 8 PM ET.  

For additional assistance with accessing PQIP, or obtaining your EIDM user role, contact the QualityNet Help Desk at 866-288-8912 or qnetsupport@hcqis.org. If you have any questions about public reporting or preview period, please contact PhysicianCompare@Westat.com.
 

10/13/2017 | Field Testing of MACRA Episode-Based Cost Measures Begins October 16, 2017

The Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, LLC, will be conducting field testing for eight episode-based cost measures before consideration of their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program. Field Testing will take place from October 16 to November 15, 2017. During this time, CRNAs and clinician groups (TINs) who are attributed episodes for performing or managing certain procedures/medical conditions will have the opportunity to view a confidential report with information about their performance. All stakeholders will be able to view a mock report and supplemental documentation on the measures that will be publicly posted. CRNA may provide feedback on the measures, confidential or mock report, and supplemental documentation through an online survey (accessible 10/16/17). 

10/5/2017 | New Qualifying APM Participant Look-Up Tool

New Qualifying APM Participant Look-Up Tool
CMS has announced the results of the first Qualifying APM Participant (QP) determinations based on eligible clinician participation in the 2017 Advanced Alternative Payment Models (APMs). We have unveiled an interactive look-up tool where many 2017 Advanced APM participants can look up their QP status based on calculations from claims with dates of service between 1/1/17 and 3/31/17 for the first QP snapshot. Under the Quality Payment Program, eligible clinicians who meet certain criteria are considered QPs in Advanced APMs, and are therefore excluded from the MIPS quality reporting program. QPs identified based on the 2017 performance year will  receive a 5 percent lump sum Medicare incentive payment in 2019. The tool will be updated soon with calculations from claims with dates of services between 1/1/17 and 6/30/17.  The Methodology Fact Sheet is an excellent resource to understand how we determine QP Status. In addition, the supplemental service payments fact sheet, which reflects the supplemental service payments included in our APM Incentive Payment calculations, is now available.

9/29/2017 | 2016 Annual QRUR Now Available for Review

The 2016 QRURs show solo-practitioners and EPs in group practices  their performance on the quality and cost measures used to calculate the 2018 Value Modifier.  An Enterprise Identity Management (EIDM) account with an appropriate role is required for EPs to obtain their 2016 PQRS Feedback Report and 2016 QRUR. 

There is a new feature on the CMS Enterprise Portal website that will allow a representative of a group or solo practitioner, as identified by its TIN to:

  1. Look up the TIN’s current and prior years’ Value Modifier and PQRS payment adjustments, and
  2. Find out which feedback reports are available for the TIN (i.e., the Annual QRUR, PQRS Feedback Report, Mid-year QRUR, and Supplemental QRUR). 

9/28/2017 | 2016 PQRS Feedback Reports Now Available

CRNAs and other eligible professionals (EPs) may now access their 2016 PQRS Feedback Reports through the CMS Enterprise Portal. The PQRS Feedback Reports show 2016 PQRS reporting results, including whether you are subject to the 2018 PQRS downward payment adjustment. An Enterprise Identity Management (EIDM) account with an appropriate role is required for EPs to obtain their 2016 PQRS Feedback Report. 
 

Notification of MIPS Participation Status

April 26, 2017 - Beginning in late April 2017 Medicare Administrative Contractors (MACs) will send clinical group practices and individual clinicians a Participation Letter notifying them whether they will be included in the Merit-based Incentive Payment System (MIPS) Program. The Participation Letter includes an attachment indicating which clinicians under the group Tax Payer Identification Number (TIN) will have to report to MIPS based on the MAC's review of clinicians Medicare Part B reimbursement claims. Clinicians who bill more than $30,000 in Medicare Part B services and who provide care to more than 100 Part B beneficiaries in the 2017 performance year are strongly encouraged to participate in the MIPS Program to avoid a 4% reduction in their Medicare 2019 reimbursements. For more information on these letters see Important Questions and Answers and visit the QPP website for more information on the MIPS Program.  

2015 PQRS Performance Scores Posted on Physician Compare

December 20, 2016 - The Centers for Medicare & Medicaid Services (CMS) has released new performance data on the Physician Compare website. The 2015 data release includes individual clinician-level PQRS measures collected via claims and registry and non-PQRS Qualified Clinical Data Registry (QCDR) as well as group practice-level PQRS measures. You can visit the Physician Compare website to see if your performance scores have been publicly reported. For more information, you can also read our FAQ page on CMS Quality Public Reporting.
 

Educational Opportunities

10/16/2017 | Upcoming Webinar: CAPG Educational Series 2017, How to Control Costs for the MIPS Resource Use Component

Learn more about the CAPG Quality Payment Program Educational Series 2017, CAPG will host its next complimentary webinar for providers and groups participating in the Quality Payment Program on December 1, 2017. Subject matter experts from CMS will review the MACRA policies for the MIPS cost category and clarify the final rule statements. CAPG members will share best practices and the rationale behind their strategies, as well as any implications for their organizations.

Title: How to Control Costs for the MIPS Resource Use Component
Date: December 1, 2017
Time: 8am - 9:30am PT / 11am - 12:30pm ET
Registration: CAPG Webinar: How to Control Costs for the MIPS Resource Use Component

 

10/13/2017 | Upcoming National Provider Calls - Field Testing

In conjunction with the field testing of eight episode-based cost measures under consideration for potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS), two National Provider Calls will be held on the dates below. The same content will be covered for both calls. Please click on the links below to register: 

During the field test, clinicians may access confidential feedback reports with information about their performance on these new measures. All stakeholders are also invited to comment on the measures and supplemental documents. The eight episode-based cost measures included in the field test are: 
  1. Elective Outpatient Percutaneous Coronary Intervention (PCI)
  2. Knee Arthroplasty
  3. Revascularization for Lower Extremity Chronic Critical Limb Ischemia
  4. Routine Cataract Removal with Intraocular Lens (IOL) Implantation
  5. Screening/Surveillance Colonoscopy
  6. Intracranial Hemorrhage or Cerebral Infarction
  7. Simple Pneumonia with Hospitalization
  8. ST-Elevation Myocardial Infarction (STEMI) with (PCI)
For more information, see the CMS webpage Merit-Based Payment System (MIPS) Episode-Based Cost Measure Field Test Reports Fact Sheet or Field Testing FAQ.  For questions, email QPPCostMeasureTesting@ketchum.com.

10/6/2017 | 2016 Annual QRUR Webcast on October 19, 2017

The Centers for Medicare & Medicaid Services (CMS) has made the 2016 Annual Quality and Resource Use Reports (QRURs) available to all group practices and solo practitioners nationwide.  2016 Annual QRURs show how groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value-Based Payment Modifier (Value Modifier) and how the Value Modifier will be applied to payments for CRNAs and other Eligible Professionals (EPs). Learn more on the 2016 QRUR and 2018 Value Modifier webpage.

This upcoming webcast provides an overview of the report and explains how to interpret and use the information.This event will be more meaningful if you have your report in front of you to follow along. Visit How to Obtain a QRUR to access your report prior to the event.  Register for this Medicare webcast today!
 

CMS Registeries

(QCDR)-Qualified Clinical Data Registries

ABG-50

ABG QCDR is a CMS Qualified Clinical Data Registry. Learn more about the Anesthesia Business Group and their QCDR. Use your AANA member ID when registering to obtain the $140 discounted rate.
QCDRs offer additional measures outside of the Anesthesia MIPS measure set.  To review additional anesthesia QCDRs please download the 2017 CMS Approved QCDR (Anesthesia) List.

Qualfied Registries

In 2017 CMS approved a multitude of CMS qualified registries to choose from.  Many of these registries are capable of processing MIPS data from measures found within the complete MIPS measure docket, like those found in the Anesthesia MIPS measure set.   Please download the MIPS 2017 Qualified Registries list today for more information. 

Contact Us

American Association of Nurse Anesthetists 
Research and Quality Division
Email: research@aana.com
Telephone: (847) 655-1170