As previously reported, the Centers for Medicare & Medicaid Services (CMS), through Yale New Haven Health Services Corporation/Center for Outcomes Research & Evaluation (CORE), has developed claims-based hospital measures to assess the quality of care provided to Medicare beneficiaries by clinicians or clinician groups who are eligible to participate under the Merit-based Incentive Payment System (MIPS). AAHKS was represented on the Work Group, which sought to “re-specify (or adapt) two hospital quality measures for the measurement of clinicians or clinician groups,” including the Risk-Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty.
AAHKS is submitting comments on the measure, which we are endorsing. You can read our comment letter, and we encourage you to comment directly to Yale CORE.
If you have not already done so, send your comments to CMSinpatientMIPSmeasures@yale.edu by 11:59 PM Eastern Standard Time on Friday, January 4, 2019. Some talking points to assist your comments include:
- Strong endorsement. Orthopaedic surgeons have long needed and requested physician/group level THA/TKA risk adjusted outcome measures.
- The attribution algorithm seems likely to appropriately identify the surgeon most responsible for the procedure and exclude other billing physicians who are not primarily leading the procedure.
- Using a measure for unique NPI/TIN combinations will effectively allow for group quality measurement, while recognizing the reality that some surgeons may practice/bill with multiple groups.
- Risks of the scores of high-performing surgeons being dragged down by poorly-performing hospitals have been tested and seems minimal.
- All aspects of the measure seem to be as accurate as possible with the available data and resources, nevertheless the measure remains a significant improvement over the prior lack of physician-specific THA/TKA measure.
