American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Quality Measures Congressional Sign-On Letter to CMS

For surgeons and their patients, implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) has fallen short on its promise of tying payment more closely to the value of care, typically described as the quality of care received for the cost to produce that care. Under the Merit-based Incentive Payment Systems (MIPS) program, most employed surgeons are ranked based on measures in the CMS Web Interface, which evaluates compliance with primary care actions such as immunizations, blood pressure control, diabetes control, and tobacco cessation. While these measures may be important to a patient’s overall health, they are not meaningful to a patient’s episode of surgical care nor do they facilitate improvement.

Meaningful measurement for surgery exists. The ACS supports surgical quality measurement that includes a combination of three elements: standards-based facility-level verification programs, patient reported experience and outcomes measures, and traditional quality measures including registry and claims-based measures. Together, these three elements provide meaningful episode-based measurement of quality for the surgeon and patient, along with actionable information necessary for improvement.

Following the advocacy efforts of ACS fellows during the 2019 ACS Leadership and Advocacy Summit, several key members of Congress sent a letter concerning surgery specific quality measures. The letter, led by Representatives Raul Ruiz, MD (D-CA), George Holding (R-NC), Brian Higgins (D-NY), and Larry Bucshon, MD, FACS (R-IN) encourages the Center for Medicare and Medicaid Services (CMS) to work with stakeholders to develop and test a quality framework that focuses on high-value processes, clinical outcomes, and patient reported outcomes and experiences.

Congressional Letter to CMS Regarding Quality Measurement