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The 2020 Quality Payment Program (QPP) Final Rule was published on November 15, 2019, and we have 5 key highlights and changes that could impact your anesthesia quality reporting:

  1. Quality measures must meet a 70% data completeness threshold. This is up from 60% in 2019.
  2. A new anesthesia quality measure #477 has been adopted by CMS for 2020. Final measure specification documentation has not been published by CMS yet, however, we would expect this to mirror the AQI measure #59 in which it is based on.

    #477 Multimodal Percentage of Patients, aged 18 years and older, undergoing selected surgical procedures that were managed with multimodal pain medicine.
     
  3. The biggest impact might be the new requirement for those electing to report as a group and attesting to improvement activities.  CMS now requires that at least 50% of the clinicians in the group must perform an improvement activity for the group to be able to attest to it.
  4. 10 additional episode-based cost measures have been approved by CMS for 2020. Trigger codes for these episodes have not been published yet so it is unknown if these will apply to anesthesia providers. In the past, ASA codes have not been included and therefore anesthesia providers have been able to avoid the application of these measures to the calculation of their final score.
  5. The performance threshold is set at 45 points to avoid a penalty for the 2020 performance year. This means most anesthesia groups/providers will need to find a reporting method that will allow them to report 6 quality measures and satisfactorily report improvement activities to meet the increasing threshold.

And don’t forget – the maximum penalty for 2020 performance is up to a 9% reduction in Medicare remittance for allowed services rendered in the 2022 payment year.

More details are available on the QPP website here.

 

abeo

abeo Management Corporation (abeo) serves as a leading source of revenue cycle management and practice management with a specialization in anesthesia. The company leverages its people, processes, and software to serve independent practices, surgery centers, hospitals and healthcare systems with a scope of services that include billing, coding, transcription, practice management, and business consulting.

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