Measuring performance a key to reimbursement

  • Measuring Physician Performance: Metrics, Money and Mandates (PN123)
  • 4-5 p.m. Saturday
  • BCEC Room 257AB

With national health expenditures topping $3.35 trillion in 2016, the U.S. leads the world in health care costs, yet is just 26th in the world for life expectancy and ranks poorly on other quality of life indicators.

To improve the value of health care spending, reimbursement for most anesthesiologists is switching to the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA). MIPS bases reimbursement on performance measures in the areas of quality, advancing care information, improvement activities and cost containment.

Nirav Shah, M.D.

“Whether we like it or not, anesthesiologists are increasingly being measured and compared with each other,” said Nirav Shah, M.D., Director of the Quality Improvement Multicenter Perioperative Outcomes Group at the University of Michigan.

Dr. Shah will moderate a session that explains how and why performance metrics for anesthesia providers are being developed. The co-moderator in the session is Robert S. Lagasse, M.D., Vice Chair of Quality Management & Regulatory Affairs in the Department of Anesthesiology at the Yale University School of Medicine. They will provide recommendations for navigating the challenges that measurement can bring.

Robert S. Lagasse, M.D.

“We will describe current quality metrics for quantifying the performance of anesthesia providers and explain how clinical performance measures are developed,” Dr. Shah said. “We’ll also identify ideal traits for performance measures and evaluate current metrics using these traits.

“If we don’t understand how CMS uses quality measurement data, we’re at risk for significant payment reduction.”

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