Medicare officials plan to require ambulatory surgical centers to report on quality measures for the first time starting in 2012.
The plan is part of a proposed rule released July 1 by the Centers for Medicare and Medicaid Services. The proposal covers Medicare payment rates and policies for hospital outpatient services and ambulatory surgical centers. In the nearly 900-page regulation, CMS officials projected that payment rates for hospital outpatient departments, not including cancer hospitals, would increase by 1.1% in 2012 and payments to ambulatory surgical centers would rise by 0.9%.
The CMS plans to launch the new quality reporting program for ambulatory surgical centers (ASCs) with eight quality measures. ASCs would report on the measures beginning in January 2012 and the information would be used to set payments for those facilities in 2014. The starter set of eight measures includes seven outcome and surgical infections measures, and one health care–associated infection measure.
Beginning in 2013, ASCs would be required to report on two more measures to be used in setting payments in 2015. Those structural measures include the use of a safe surgery checklist and the collection of ASC volume data on selected surgical procedures. Also in 2013, ASCs would begin reporting on a measure on influenza vaccination coverage among health care workers. That information wouldn’t be used for payment purposes until 2016.
The Medicare proposed rule also expands the quality reporting program for hospital outpatient departments. The CMS is proposing to add nine quality measures for outpatient departments, bringing the total number of measures to 32.
The nine new measures include six chart abstracted measures, one health care–associated infection measure, one measure on the use of a safe surgery checklist, and one measure collecting hospital outpatient department volume for selected surgical procedures. The data collected through these new measures would be used in setting payment rates for 2014, according to the CMS.
The agency also is proposing that outpatient departments begin measuring influenza vaccination coverage among their staff. That information would be used in setting the 2015 Medicare payment rates.
The proposed rule provides new details on what the Hospital Inpatient Value-Based Purchasing Program will look like in 2014. The program is a new initiative that will take 1% of the Medicare payments to hospitals and put them in a fund to pay for care based on quality starting in October 2012. Under the hospital outpatient proposed rule, the CMS outlined its plans to add a new clinical process of care measure on infections from urinary catheters in fiscal year 2014. This measure would be added to the 12 clinical process of care measures that are already part of the program. The hospital outpatient department proposed rule also includes new details on the performance periods, standards, and weighting schemes that would be used for the Hospital Inpatient Value-Based Purchasing Program in fiscal year 2014.
The CMS will accept comments on the proposal until Aug. 30. A final rule is expected by November.