Feel like losing two percent of your ASC’s Medicare reimbursement in 2019? We didn’t think so. But if you’re a physician-owner and your center isn’t acing participation in the ASC Quality Reporting Program (ASCQR), that’s exactly what’s going to happen.The deadlines have passed that affect your payment in 2018, but there’s still a chance to avoid this payment pitfall in 2019 and beyond.
CMS is famous for its “carrot and stick” approaches to quality reporting, offering incentives as well as penalties depending on a provider’s level of participation. However, ASCQR is definitely just a stick. There’s no bonus for participating, but there’s a clear downside if you don’t. “CMS calls it a pay-for-reporting system, but it’s actually a fine-for-not-reporting system,” clarifies Mike Schmidt, director of certification and client success for Eye Care Leaders.
“If you don’t report certain data on your ASC’s safety and services, your ASC stands to lose two percent of your Medicare reimbursements.”—Mike Schmidt
ASCQR Quality Measures
Reports on quality measures from the 2017 data collection period are due by May 15, 2018. This submission affects your 2019 reimbursement level, so be sure to mark your calendars. You must report eight mandatory measures, plus one voluntary measure (ASC-11). You can find them listed here.
Report quality measures in two ways:
- Five of the measures are claims-based—they are gleaned from your Medicare claim forms and require no action from you. These are called Quality Data Codes (or G-codes). G-codes report on incidents like burns, falls, or physician errors that take place at your ASC.
- You report the rest of the measures through the contractor QualityNet’s online portal. (The exception is ASC-8, which you’d online through the National Healthcare Safety Network).
If you own a single-specialty ophthalmic ASC, you won’t be performing some of the quality measures (like those referring to endoscopies). However, you must still report the measures by entering “zero” for the numerator and denominator.
Eyes Open: Your Performance Counts
Your performance on quality measures is publicly available on CMS’ Hospital Compare website. Consumers may visit Hospital Compare to help them make decisions about where to go for care. Your performance won’t affect your reimbursement under ASCQR. But, poor performance could still impact your revenue by affecting a patient’s decision to visit your center.
Stay tuned for part two of our series on ASCQR: the OAS CAHPS survey…