In April, the Centers for Medicare & Medicaid Services (CMS) certified the Anesthesia Quality Institute's (AQI) National Anesthesia Clinical Outcomes Registry (NACOR) as a qualified clinical data registry (QRDC), opening up more options for anesthesiologists who want to participate in the Physician Quality Reporting System (PQRS) program. Previously, anesthesiologists were limited to reporting three measures to PQRS, and now they have the ability to submit data on more than a dozen other anesthesia-related measures.
CMS introduced the QRDC as a new PQRS reporting mechanism in 2014, and it's expected that CMS will gradually phase out claims-based reporting in favor of registries over the next few years. This change gives specialty societies, such as the American Society Anesthesiologists the opportunity to develop meaningful measures that reflect specialty-specific priorities and instances of care. In addition, it allows registries such as NACOR to report on measures already part of the PQRS program as well as specialty-based, registry-developed measures.
NACOR now offers 19 measures, eight of which are established PQRS measures, while the other 11 are registry-specific measures. Together, these measures cover four National Quality Strategy (NQS) domains.1
New QCDR Registry Measures include:
- Post-anesthestic transfer of care: Use of checklist or protocol for direct transfer of care from procedure room to Intensive Care Unit
- Post-anesthestic transfer of care measure - procedure room to post-anesthesia care unit
- Prevention of post-operative nausea and vomiting - combination therapy (adults)
- Prevention of post-operative vomiting - combination therapy (pediatrics)
- Composite anesthesia safety
- Immediate perioperative cardiac arrest rate
- Immediate perioperative mortality rate
- PACU reintubation rate
- Short-term pain management
- Composite procedural safety for central line placement
- Composite patient experience measure
The QCDR option has far-reaching implications related to how anesthesiologists and eligible providers (EP) may receive the 2014 payment incentive and avoid the 2016 payment adjustment. To qualify for a PQRS incentive, an EP must report on a minimum of nine measures covering three NQS domains for at least 50% of the EP's applicable patients seen during the 2014 reporting period. At least one of the measures an EP reports must be an outcomes measure. To avoid the 2016 payment adjustment, an EP must report on at least three measures covering one NQS domain for at least 50% of the EP's applicable patients during the same period.
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