Anesthesiology to introduce its own set of metrics

PN211 - The Present and the Future of Quality Improvement
Sunday, October 23 | 1:15-2:15 p.m.
Room 211-213

Quality improvement measures, definitions, and practices are on the move. Even as anesthesia moves toward launching one of the first sets of quality measures tailored for, and by, a specific medical specialty, private practices are implementing their own quality measures and practices. And for the first time, both sustainability and equity are poised to become practical tools to evaluate and improve quality of care.

“For the first time, starting in 2023, anesthesiology will have its own set of quality metrics developed with input from anesthesiologists, the ASA, the Centers for Medicare & Medicaid Services (CMS), and other stakeholders for the newest edition to the Quality Payment Program,” said Vilma A. Joseph, MD, MPH, FASA, Professor of Anesthesiology at Albert Einstein College of Medicine in the Bronx, New York. “This measure set will help us in the transition away from MIPS, the Merit-Based Incentive Payment System, to the MIPS Value Pathway (MVP) for reimbursement.”

Dr. Joseph will discuss the upcoming transition from MIPS to MVP and the impact on anesthesiologists, their institutions, and their payments during the Sunday session “The Present and the Future of Quality Improvement.”  

Anesthesia is one of just seven MVP quality sets approved by CMS for use in 2023, Dr. Joseph noted. Others include rheumatology, stroke care, heart disease, chronic disease management, emergency medicine, and lower-extremity joint repair. CMS’ stated goal with MVP is to support patient-centered care, a continuing emphasis on the importance of patient outcomes, population health, health equity, interoperability, and reduced reporting burdens for clinicians.

“CMS is willing to understand that even though there may be financial risks, taking care of patients in a holistic way provides the best outcomes,” Dr. Joseph said. “This is really an extension of what we have been talking about for years with the Perioperative Surgical Home. We will be leaders in perioperative care, interacting with the various specialties, understanding the global picture of health care, and enhancing outcomes. This is an opportunity for anesthesiologists to work more closely with their health systems to enhance care.”

Some private practices already are. US Anesthesia Partners (USAP) in Dallas is taking the lead with hospitals and surgeons to contact patients with all the relevant information for surgery, not just anesthesia-specific details,  in its practices across seven states.

“Once a patient is scheduled for surgery, they get a message from us with all the practical details,” explained Richard Dutton, MD, MBA, FASA, Chief Quality Officer for USAP. “Here’s what to expect, here are your anesthesia options, what to eat before surgery, medications to take and skip, how much pain you are likely to experienced and how it is going to be managed, where to park, where your family can wait, when you can expect to go home. This is the Perioperative Surgical Home and enhanced recovery programs in action – team-based, evidence-based care where we are all on the same page and working together to get the patient on that page as well.”

The goal, he said, is to improve patients’ satisfaction with their care as well as outcomes. Patients who are happier about their surgical care are more likely to keep up with copays and deductibles – and more likely to support clinicians in disputes with payers.

“Some day, some payer will recognize the value that good anesthesia programs can bring them,” Dr. Dutton said. “That day is not today, though. We use positive patient comments in our arbitration filings and legal battles with payers. Engaging patients is central to our practice. Not only is it good for patients and outcomes, it’s good business as well.”

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