Participate in an Online Survey to Test MACRA Episode-Based Cost Measures

Members & Publications

October 19, 2017

The Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, LLC, are conducting field testing for 8 episode-based cost measures and the measure reporting format. This feedback will help determine whether these measures should be included in the Quality Payment Program, and how the measures and reporting format should be improved to provide clinicians actionable information to ensure high-quality and high-value care.

Interested members can participate in this testing now through November 15, 2017 by downloading their confidential report through the CMS Enterprise Portal and participating in  an online survey at: https://www.surveymonkey.com/r/macra-cost-measures-field-testing.

The episode-based cost measures, which will be reported during field testing to group practices and solo practitioners who meet a 10-episode case minimum for at least 1 measure during the measurement period of 06/01/16 to 05/31/17, are the following:

  • Elective Outpatient Percutaneous Coronary Intervention (PCI)
  • Knee Arthroplasty
  • Revascularization for Lower Extremity Chronic Critical Limb Ischemia
  • Routine Cataract Removal with Intraocular Lens (IOL) Implantation
  • Screening/Surveillance Colonoscopy
  • Intracranial Hemorrhage or Cerebral Infarction
  • Simple Pneumonia with Hospitalization
  • ST-Elevation Myocardial Infarction (STEMI) with PCI

Access to Reporting and Performance Data
During the survey period, clinicians and clinician groups (TINs) who are attributed episodes for performing or managing the procedures/medical conditions listed above will have the opportunity to view a confidential report with information about their performance. All stakeholders will also have access to a mock report and supplemental documentation on the measures that are publicly posted (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html).

Your Feedback Matters

CMS is looking for feedback on these types of questions:

  • Does the information presented on the measure in the field test report and accompanying documentation help you identify actionable improvements to patient care and to cost efficiency?
  • Are the measure specifications for the 8 episode-based cost measures clinically valid? Measure specifications include episode triggers, attribution, assigned services, episode windows, and risk adjustment.
  • How can the information be presented in such a way that it is most useful for quality improvement?
  • How understandable is the measure documentation provided, and what portions of the documentation could be clearer or more detailed?
  • Would any additional documents or information be useful to help clinicians and other stakeholders understand these measures?

Physiatry’s Contribution to This Effort
Three Academy members, Drs. Kirk Whetstone, Chloe Slocum, and Andrew Gordon, were instrumental in developing the knee arthroplasty measure; serving on a Clinical Subcommittee to provide detailed clinical input on preliminary measure specifications during in-person and webinar meetings convened between May and August 2017.

Where to Find More Information
In conjunction with field testing activities, 2 National Provider Calls will be held to provide additional information on field testing and include a Q&A session. The same content will be covered on both calls. Click on the link below to register for the date/time that works best with your schedule.

Questions should be directed to: QPPCostMeasureTesting@ketchum.com

Click here for an overview of the policy background, measure development process, and details of field testing activities.

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.