The ASC industry is applauding the Department of Health and Human Services' proposed framework for a value-based purchasing program for ambulatory surgery centers but remains concerned about the lengthy timetable expected for the program's implementation.
In a 33-page report to Congress yesterday, HHS Secretary Kathleen Sebelius outlines how an ASC value-based purchasing (VBP) program, "using a continuous quality improvement framework, would reward high-quality ASCs and align with initiatives under other Medicare quality incentive programs."
Quality measures that would be considered under the program include: patient falls and burns; hospital transfers and admissions; wrong-site, -side, -patient, and -implant surgeries; prophylactic antibiotic administration; surgical site hair removal; surgical site infection; medication administration and reconciliation; and venous thromboembolism measures. Facilities that report and show high levels of quality on those measures would be rewarded with higher payments under the VBP program.
In a press release commending HHS for the VBP framework, ASC Association Executive Director William Prentice says the organization is "pleased to see that so many of the recommendation that the various members of the ASC community have suggested and supported over time have been included in this plan." Specifically, the industry supports HHS' "acknowledgement of the need to align measures across payment systems and the importance of minimizing the reporting burden associated with VBP," as well as the plan's inclusion of a "multi-stakeholder process for measure selection," "claims-based reporting as one of several reporting options," and a shared savings plan as one of several quality-bonus funding options.
But while supporting the substance of the plan, ASCA "remain[s] concerned that the quality reporting program will not be implemented in the near future, and we would like to see that timetable stepped up," says ASCA Board Chair David Shapiro, MD. In the report to Congress, Ms. Sebelius notes that her department currently lacks the authority to enact the VBP plan for ASCs. Mr. Prentice says ASCA is working with other members of the ASC community "to introduce legislation that would give HHS that authority."
Irene Tsikitas
