Quality Payment Program changes on the horizon
How is anesthesiology impacted?
In 2023, significant changes were made to the Quality Payment Program (QPP), including a voluntary transition from the traditional Merit-based Incentive Payment System (MIPS) to MIPS Value Pathways, or MVPs.
The QPP was established by the Centers for Medicare & Medicaid Services (CMS) with the idea of promoting cost-effective, high-quality care for patients on Medicare and Medicaid.
“It is constantly evolving, and as physicians we must be prepared for these changes,” said Vilma Joseph, MD, MPH, FASA, Professor of Anesthesiology and Site Director for Anesthesia Services at Albert Einstein College of Medicine and Montefiore Medical Center in Bronx, New York.
Dr. Joseph was one of four presenters discussing the new changes at the 2023, “Quality Payment Program: Where We Are Now and Where We Are Going.”
Although the changes in 2023 were voluntary, they are a step toward requirements that will be in place by 2026. Dr. Joseph said it’s important for anesthesiologists to prepare today for how they can be a part of those changes.
“Physicians can achieve a positive incentive in this new landscape,” she said. “In addition to discussing how, we will analyze various quality measures from the Anesthesia Quality Institute National Anesthesia Clinical Outcomes Registry that are used in QPP.”
These changes won’t just apply to those in hospital settings, either. Richard Dutton, MD, MBA, FASA, Chief Quality Officer at U.S. Anesthesia Partners in Dallas, Texas, said the private sector is working on multiple quality initiatives.
“That includes leveraging routine clinical practice for pragmatic research, making the pivot from MIPS to MVP as federal quality payment programs continue to evolve, and facility collaborations – such as preoperative teaching and postoperative surveys – to improve patient engagement,” Dr. Dutton said.
One area that is seeing increased focus as a quality metric is regional anesthesia. Nabil Elkassabany, MD, MSCE, MBA, Professor and Vice Chair of Clinical Operations in the Department of Anesthesiology at the University of Virginia in Charlottesville, said regional anesthesia has a proven track record of improving patients’ outcomes after certain orthopedic procedures. Because of this, various quality metrics have been established to gauge the level and for which regional anesthesia is used in these procedures. This has proven useful as CMS and other payers have adopted some of these outcome metrics for their alternative payment methods.
“As anesthesiologists, we tend to think about pain management as a team sport, where all perioperative stakeholders have input in improving patients’ experiences,” Dr. Elkassabany said. “The concept of multimodal analgesia has been adopted in practice as a benchmark for quality and as part of value-based payment models. There are various quality metrics that have been developed around the use of regional anesthesia and acute pain medicine in everyday practice.”
