Monday, 07 November 2016 20:37

Quality Measures Added in 2017 for Hospital Outpatient Services and ASCs

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On Tuesday, Nov. 1, 2016, the Centers for Medicare and Medicaid Services (CMS) released the final 2017 Outpatient Perspective Payment System (OPPS) rule. CMS stated in its fact sheet that “these finalized policy changes will improve the quality of care Medicare patients receive by better supporting their physicians and other healthcare providers and (reflecting) a broader Administration-wide strategy to create a healthcare system that results in better care, smarter spending, and healthier people.”

CMS will be removing from the 2017 patient satisfaction survey questions on pain management. CMS has said that it is not aware of any research to support an association between the patient satisfaction survey questions on pain management and the national opioid epidemic; however, due to multiple government agencies attempting to address this epidemic, the questions will be removed and alternate questions developed for future use.

CMS is adding seven measures to the Hospital Outpatient Quality Reporting Program for the 2020 payment determination and subsequent years.

Two are claims-based measures:

  • OP-35:  Admissions and Emergency Department Visits for Patients Receiving Outpatient Chemotherapy
  • OP-36: Hospital Visits after Hospital Outpatient Surgery

Five are Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OASCAHPS) Survey-based measures:

  • OP-37a: OASCAHPS - Facilities and Staff
  • OP-37b: OAS CAHPS - Communication about Procedure
  • OP-37c: OAS CAHPS - Preparation for Discharge and Recovery
  • OP-37d: OAS CAHPS - Overall Rating of Facility
  • OP-37e: OAS CAHPS - Recommendation of Facility

CMS is also making changes under the Medicare Electronic Health Record (EHR) Incentive Program for eligible hospitals and critical access hospitals attesting to CMS, including hospitals that are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs (dual-eligible hospitals), by eliminating the clinical decision support (CDS) and computerized order entry (CPOE) objectives and measures, beginning in 2017. CMS is reducing a subset of thresholds for the remaining objectives and measures for modified Stage 2 and Stage 3. Additional changes include allowing all returning participants in the EHR incentive programs to report on a 90-day EHR reporting period in 2016 and 2017. CMS is also finalizing an application process for a one-time, 2017 significant hardship exception to the Medicare EHR Incentive Program for certain eligible professionals who are also transitioning to the Merit-Based Incentive Payment System (MIPS). These additions increase flexibility, lower the reporting burden for providers, and focus on the exchange of health information and using technology to support patient care.

The OPPS /ASC Final Rule and IFC are available in the Federal Register, and accessible online.

A fact sheet on this final rule and IFC is available online.

About the Author

Kim Charland is the editor of VBPmonitor and the senior vice president of clinical innovation with Panacea Healthcare Solutions. Kim has 30 years of experience in health information and reimbursement management for hospitals and physician offices. Kim’s primary role with Panacea is publisher of VBPmonitor.com, which is the company’s newest online monitor and is focused on value-based purchasing and quality. She is also co-host of ICD10monitor.com’s Internet news broadcast Talk-Ten-Tuesdays. In addition, she assists with product development for Panacea’s consulting and software divisions, as well as the MedLearn publishing division. Kim is also recognized as a national speaker who has spoken for numerous organizations.  Kim is also the president-elect for the New York Health Information Management Association.

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Last modified on Tuesday, 08 November 2016 00:45