On July 15, 2022 the Centers for Medicare and Medicaid Services (CMS) released the 2023 Ambulatory Surgical Center Quality Reporting Program (ASCQR) Proposed Rule. This blog post breaks down the proposed changes to the ASCQR and requests for feedback.
2023-2024 Proposed Changes
CMS is not proposing any changes for the 2023 and 2024 reporting periods.
2025 Proposed Changes
CMS is proposing to make the following measure voluntary: ASC-11: Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery
Requests for Comment on Potential Future Changes
CMS included three significant requests for comment in this proposed rule. These are changes under consideration for proposal in a future rule. Comments submitted to CMS on these topics have the potential to impact future proposed changes as they are in development.
Potential Future Specialty Centered Approach for the ASCQR Program
CMS is considering implementing a specialty-centered quality reporting approach for ASCs that is similar to MIPS quality reporting. Specifically, CMS is requesting comment on a couple of approaches under consideration:
Both of these approaches would include quality measures more similar to what is seen in MIPS. CMS also believes these approaches would benefit from promoting subgroup reporting. Subgroup reporting allows single specialty subgroups in a larger group (e.g., all ophthalmologists in an ASC) to report separately on a specialty-specific set of measures.
CMS specifically calls out ophthalmology as an example of a specialty that would be impacted by these potential future changes.
Potential Future Reimplementation of ASC Facility Volume Data on Selected ASC Surgical Procedures (ASC-7) Measure or Other Volume Indicator
CMS is considering reimplementing ASC-7 to track procedure volumes for public reporting. This is a measure of facility capacity and surgical procedure volume data on six categories of procedures frequently performed in the ASC setting: Gastrointestinal, Eye, Nervous System, Musculoskeletal, Skin, and Genitourinary. CMS states that volume is an important component of quality as higher procedure volume is associated with better outcomes. By making this metric viewable on Care Compare, CMS believes that patients will be able to make more informed choices.
CMS is specifically requesting comment on whether ASC-7 or another volume indicator measure would be feasible and on what timeline would be appropriate for public reporting.
Interoperability Initiatives in ASCs
CMS wants to promote meaningful electronic health record (EHR) use in ASCs. They site a 2021 Ambulatory Surgical Center Association EHR utilization survey, showing that 54.6% of ASCs use an EHR in their facility, indicating that ASCs have a lower adoption rate compared to the 85.9% of office-based physicians reported by ONC.
Steps CMS is considering toward this goal include:
Next Steps
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