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

ACS Medicare Advanced Alternative Payment Model Clears Key Hurdle

The Physician-Focused Payment Model Technical Advisory Committee (PTAC), on April 11, recommended that the Secretary of the U.S. Department of Health and Human Services (HHS) approve the American College of Surgeons (ACS)-Brandeis Advanced Alternative Payment Model (A-APM) for limited-scale testing.

The ACS-Brandeis A-APM is an episode-based payment model that uses software to process and group claims data using physician-reviewed clinical specifications, including trigger codes and relevant services. The model measures quality across the phases of surgical care and couples high-value process measures with patient-reported outcomes. Participants can be rewarded for reducing unwarranted variation and providing efficient, high quality care. The ACS began developing the model by working with a team at Brandeis University, Waltham, MA, soon after passage of the Medicare Access and CHIP (Children’s Health Insurance Plan) Reauthorization Act (MACRA) of 2015, with the goal of providing more surgeons with the opportunity to participate in the law’s A-APM track.

The PTAC was created under MACRA to spur development of new APMs for Medicare-participating physicians. The ACS-Brandeis A-APM was the first submission that the PTAC received last December and was one of two proposals approved at the April meeting. The PTAC will next send a formal report with its recommendation to the HHS Secretary, who will review the recommendation and decide whether the proposal should be sent to the Centers for Medicare & Medicaid Services for implementation.  

For more information, contact Matt Coffron, ACS Manager of Policy Development, at mcoffron@facs.org.

CMS Releases FY 2018 IPPS Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) released its fiscal year (FY) 2018 Inpatient Prospective Payment System (IPPS) proposed rule April 14. CMS proposes to increase operating payment rates by 1.6 percent for general acute care hospitals that are paid under the IPPS rule, if they successfully participate in the Hospital Inpatient Quality Reporting Program and engage in meaningful use of electronic health records (EHR). Other proposed payment adjustments include continued penalties for excessive hospital readmissions, a continued 1 percent penalty for hospitals in the lowest-performing quartile under the Hospital-Acquired Condition Reduction Program, and continued upward and downward adjustments under the Hospital Value-Based Purchasing Program.

CMS also proposes modifications to the previously finalized clinical quality measures (CQMs) reporting requirements under the EHR Incentive Program. The proposed changes would require that eligible hospitals submit at least six CQMs from two self-selected calendar year quarters in 2017 and from the first three calendar-year quarters in 2018. In addition, the proposed rule comprises new policies that would eliminate payment adjustments for clinicians who furnish all of their services in an ambulatory surgery center, and for eligible hospitals that demonstrate that compliance with meaningful use of EHR is not possible under the Office of the National Coordinator for Health Information Technology’s Health IT Certification Program.  

The American College of Surgeons is evaluating these and other proposals to determine the impact on surgery and will submit comments to CMS. The proposed rule is available for public review, along with a fact sheet on its payment and quality aspects. For more information, contact regulatory@facs.org.

Register Now for 2017 ACS Quality and Safety Conference

2017 Quality and Safety ConferenceRegistration for the 2017 American College of Surgeons (ACS) Quality and Safety Conference is now open. The meeting will take place in New York, NY, July 21–24 at the New York Hilton Midtown and the Sheraton New York Times Square Hotels.

The theme of the inaugural Quality and Safety Conference—formerly the ACS National Surgical Quality Improvement Program (ACS NSQIP®) Annual Conference—is Achieving Quality: Present and Future. The program will offer discipline and theme-based tracks focused on the specifics needs of various learner groups from the following ACS Quality Programs:

Presenters and organizers are striving to provide a forum that achieves the following goals:

  • Offers opportunities to share knowledge pertaining to local, national, and international quality improvement initiatives in surgery
  • Describes methods used to analyze clinical registry data and demonstrate practical ways to use the data
  • Assists hospitals in analyzing, managing, and interpreting data by providing education on proven methods that lead to positive change
  • Enhances the learning experience by offering breakout session that educate attendees on topic areas of interest

Keynote speaker Blake Haxton, a member of the 2016 U.S. Paralympic Team in rowing, will share his unique insight into successfully recovering from necrotizing fasciitis. 

Additional session highlights are as follows:

  • How to Become an ACS Quality Improvement (QI) Facilitator
  • Hot Topics in Surgical Quality and Safety
  • Patient-Reported Outcomes
  • What Residents Should Know about Policy, Quality Improvement, and Research
  • Emotional Intelligence in Quality and Safety
  • ACS Quality Programs and Registry Updates

A schedule overview, the conference brochure, hotel accommodations, and registration fee information are available on the ACS Quality and Safety Conference website. Space is limited, and registration will be on a first-come, first-served basis.

Reminder: CMS Call on Reporting Global Codes Set for April 25

The American College of Surgeons (ACS) encourages members who are subject to the Centers for Medicare & Medicaid Services (CMS) reporting requirements for 10- and 90-day global services to participate in a CMS teleconference, 1:30−3:00 pm EDT, April 25. This call will provide information regarding the new reporting requirements, along with reporting resources and tools.

The rule takes effect July 1 and applies to practitioners who furnish 10- and 90-day global services on a CMS list of 293 codes and who are in practices with 10 or more other practitioners in any of nine selected states—Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island. These practitioners will be required to report Current Procedural Terminology (CPT) code 99024 for each postoperative visit related to the specified codes for services that they provide to a Medicare beneficiary.

The call will include a question-and-answer period. Coders, billers, and practice managers in the nine selected states are encouraged to participate as well. Details about the call, including registration information, are posted on the CMS website.

More information about the global codes policy is available on the ACS website and the CMS website. Surgeons who have difficulty complying with this policy or who have questions should contact the ACS Division of Advocacy and Health Policy at regulatory@facs.org.

New Video Highlights ACS Fundamentals of Surgery Curriculum

The ACS Fundamentals of Surgery Curriculum® (ACS FSC) is a highly interactive, case-based, online curriculum that addresses the essential content areas that all surgical residents need to master in the early years of training. The curriculum includes more than 110 simulated case scenarios in which residents are asked to recognize and assess symptoms and signs, order appropriate tests and procedures, evaluate data, and initiate appropriate actions.