Until now, claims-based reporting has been the only Physician Quality Reporting System (PQRS) option for most anesthesiologists. While the method of reporting, inserting the five-digit PQRS codes for the PQRS measures on one’s Medicare claims, has been easy enough, finding enough quality measures that apply to anesthesia practices has been more of a challenge.
The picture changed when the Anesthesia Quality Institute’s (AQI) National Anesthesia Clinical Outcomes Registry (NACOR) received Qualified Clinical Data Registry (QCDR) status a little more than a month ago. As stated on the CMS QCDR web page:
A qualified clinical data registry (QCDR) is a new reporting mechanism available for the Physician Quality Reporting System (PQRS) beginning in 2014. A QCDR will complete the collection and submission of PQRS quality measures data on behalf of Eligible Professionals (EPs). For 2014, a QCDR is a CMS-approved entity that collects medical and/or clinical data for the purpose of patient...
For the first time, we are using an issue of the Alert to reproduce a third-party article in full. Dr. Steven Boggs’s thoughts on “anesthesiologists as operating room directors” add such a lot to the concept of “anesthesiologists as medical directors” that they deserve to be read unabridged, undiluted and unencumbered by extraneous ideas. We are grateful to Dr. Boggs and to PhySynergy for granting us permission to publish this article, which appeared on PhySynergy’s AnesthesiaReviews Blog on March 10, 2014.
Anesthesiologists as Operating Room Directors: The Advantages
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“The only thing worse than a coach or CEO who doesn't care about his people is one who pretends to care. People can spot a phony every time.”Jimmy Johnson
What is the advantage or even usefulness of having an anesthesiologist as an Operating Room (OR) director? I have been asked to answer that question, However, I first must consider some of...
Under CMS’ current Medicare and Medicaid electronic health record (EHR) incentive program regulations, eligible professionals (EPs) must use 2014 edition certified EHR technology (CEHRT) to demonstrate meaningful use for either Stage 1 or Stage 2 in 2014. Many EHR vendors have not yet met the criteria to obtain certification for the 2014 edition, or they have too large a backlog of installations to comply with the timeline, however. On May 20th, CMS issued a proposed rule that would push back the deadlines for implementation of 2014 edition systems for the Medicare program.
The proposed rule offers EPs substantial flexibility in selecting meaningful use criteria from 2011, 2013 and/or 2014 to attest for Stages 1 or 2 in 2014. An EP who cannot fully implement 2014 criteria this year can attest using 2011 criteria (including enhanced criteria under a 2013 upgrade of the 2011 edition). Thus, EPs (1) would be able... 
Aetna, Humana and UnitedHealthcare have announced plans to establish an online database of paid claims that will give consumers, employers and federal and state governments information about the price and quality of healthcare services.
The announcement follows closely behind CMS’ public release, on April 9, 2014, of line-item data on $77 billion paid out to more than 880,000 physicians and other Medicare Part B suppliers in 2012. (See April 21, 2014 Alert: How Much Did Medicare Pay Each of 32,641 Anesthesiologists in 2012?)
In 2011, Aetna, Humana, UnitedHealthcare and Kaiser Permanente created the Health Care Cost Institute (HCCI) to provide data to qualified researchers on more than 5 billion claims dating from 2000. This database allowed HCCI to release three annual healthcare cost and utilization reports that tracked trends in national healthcare spending.
The purpose of compiling the data was to promote better understanding of the drivers of escalating healthcare costs. The database also...
Anesthesiologists are automatically exempt from the meaningful use requirement and from penalties in 2015 as long as they have registered in the Provider, Enrollment, Chain and Ownership System (PECOS) using anesthesiology’s specialty designation (05). Any anesthesiologist who is at all unsure should check that he or she has created an account in PECOS and that the information is correct—also before July 1, 2014. Hospital-based anesthesiologists are not merely excepted; they are excluded from the EHR incentive program altogether and can neither earn the bonus nor be subjected to penalties. “Hospital-based” is defined narrowly under the program’s rules, however: the EP must provide 90 percent or more of his or her covered services in a hospital inpatient or emergency room setting. Most anesthesiologists do not provide anything like 90 percent of their covered services in the hospital inpatient or ER setting unless their practice is limited to cardiac, transplant or critical care work....