Program Announcements

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1 2013 Data Analysis from the Ambulatory Surgical Center Quality Reporting (ASCQR) Program: What Have We Learned? April 23, 2014 Program Announcements Implementation of ASC-11 has been delayed until January The Centers for Medicare & Medicaid Services (CMS) has delayed implementation of ICD-10 until Please remember to keep your facility s Security Administrator (SA) contact information current. A back-up SA is highly recommended. The requirement for reporting the claims-based measures is 50 percent or greater for Quality Data Code (QDC) data submission via claims. 2 Save the Date Next ASCQR Program educational webinar: July 23: Proposed 2015 OPPS/ASC Rule Registration announcement will be sent via the ASCQR ListServe Registration and handouts will be posted at 3 1

2 Learning Objective At the conclusion of this program, attendees will be able to discuss the implications of the 2013 national data summary from ASCQR Measures 1 5 and the 2013 ASCQR web-based measures Data Analysis from the Ambulatory Surgical Center Quality Reporting (ASCQR) Program: What Have We Learned? Reneé Parks, RN, BSN Project Coordinator, FMQAI 5 ASCQR Data The data are presented in two parts: QDC use and ASC Measures 1 5. All data are preliminary. Overall data for QDC use and ASC distribution are shown. Data are divided by facility characteristics (e.g., location, size, and claim time period). 5,065 ASCs, as defined by national provider identifier (NPI), had Medicare Fee-for-Service claims in calendar year (CY) million ASC claims were submitted in CY All data were generated on February 15, 2014, for this presentation with dates of service from January 1 December 31, Medicare Administrative Contractors (MACs) have until April 30, 2014, to process claims for this program submitted in CY

3 Why Analyze the Data? Data analysis is completed to review progress of measures Benchmarking National State Year-over-year comparison Overall performance of participation in quality improvement program Variations within the ASC community 7 ASC Claims Distribution by CMS Region CMS States Region 1 CT, ME, MA, NH, RI, VT 2 PR, VI, DN, QN, UN, NJ, NY 3 MD, DC, DE, WV, VA, PA NC, SC, TN, FL, GA, AL, KY, 4 MS 5 MI, MN, OH, IL, IN, WI 6 TX, LA, AR, OK, NM 7 MO, KS, IA, NE, EM, WM 8 ND, UT, SD, WY, CO, MT 9 NV, AS, AZ, CA, GU, HI 10 WA, AK, ID, OR 8 ASC Distribution of Claims Volume by Facility Size: CY

4 ASC Distribution of Claims Volume by Facility Size by Quarter: CY 2013 Q Q Q Q Source: FMQAI, the Ambulatory Surgical Center Quality Reporting Support Contractor 10 National ASC QDC State Level Data: Q National ASC QDC State Level Data: CY

5 ASC Specialty Specialty defined by types of procedures submitted for payment Based on organ systems defined in the Specifications Manual and corresponding Healthcare Common Procedure Coding System (HCPCS) codes If a facility performs two or more organ system procedures that each account for 5 percent of the facility s claims, it is defined as multi-specialty Other category is defined as genitourinary, musculoskeletal, respiratory, skin, and other specialties not listed in the manual 13 ASC Distribution by Specialty: CY ASC Volume by Specialty: CY

6 QDC Rates by Specialty: CY National QDC Rates by Quarter 17 Medicare Claim Proportion by Quarter 18 6

7 National QDC Submission Rates by Quarter and Specialty 19 National QDC Submission Rates by Quarter and Specialty (continued) 20 QDC Rates by ASC Size by Quarter 21 7

8 Proportion of ASCs with Over 50% QDC Submission Rate by Quarter 22 ASCs with Over 50% QDC Submission Rates by Specialty: CY ASCs with Over 50% QDC Submission Rates by CMS Region: CY

9 ASCs with Over 50% QDC Submission Rates by Quarter and Size: CY QDC Data Overview National QDC submission rates at 91.45% State-level QDC rates continue to improve with rates ranging from 69% to 98% QDC rates by specialty continue to improve with rates from 88% to 94% QDC rates vary by ASC size and specialty Overall QDC participation is high 26 Rates for Measures 1-4 by Quarter (Per 1,000 Visits) (787/4,876,320) (568/4,874,527) (149/4,874,393) (2,569/4,874,747) 27 9

10 Q and CY 2013 Submission Rates for Measures 1-4 Per 1,000 Visits 28 Timely Prophylactic IV Antibiotic Administration by Quarter Per 1,000 Visits (Timely IV antibiotic use in CY 2013: 429,788/445,738) 29 Q and CY 2013 Submission Rates for ASC-5 Per 1,000 Visits 30 10

11 Claims-Based Measures Overview Preliminary data CY 2013 data were run February 15, million claims submitted ASC-1 4 are rare, isolated events that do occur ASC-5 demonstrates appropriate and timely use of antibiotic therapy National and state benchmarks are available for facility comparison 31 ASCs Submitting Measures 6 and 7 by Specialty: CY ASCs Submitting Measures 6 and 7 by Size: CY

12 ASCs Submitting Measures 6 and 7 by CMS Region: CY Web-Based Measures Overview Preliminary Data 2012 Events reported July 10, 2013 August 23, 2013 through QualityNet Secure Portal Larger volume ASCs show a higher percentage of reporting web-based measures than smaller volume facilities Specialties with high reporting rates are Eye, GI, and Multiple Specialties No web-based measures to report on in CY 2014 Room for improvement Next web-based measure submission period will be January 1 August 15, Sample Preliminary CY 2013 Data Report 36 12

13 Sample Preliminary CY 2013 Data Report (continued) 37 Sample 2013 Claims Data Analysis 38 Preliminary Claims Data by Specialty 39 13

14 Sample QDC Submission Rates by County 40 Preliminary QDC Submission Rates by State 41 Sample Measure Rates Per 1,000 Claims 42 14

15 Preliminary Measure Rates by Specialty 43 What Have We Learned? Program participation continues to grow Measures ASC-1 4 are rare, isolated events that do occur Measure ASC-5 rate is high Web-based measures reporting has room for improvement Program continues to grow with new measures Facility size, specialty, and geographic location are variables that impact the data Software and billing processes require monitoring 44 Continuing Education Approval This program has been approved for 1.0 continuing education (CE) unit given by CE Provider # for the following professions: Florida Board of Nursing Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling Florida Board of Nursing Home Administrators Florida Council of Dietetics Florida Board of Pharmacy Professionals licensed in other states will receive a Certificate of Completion to submit to their licensing Boards

16 CE Credit Process Complete the WebEx survey you will receive by within the next 48 hours. The survey will ask you to log in or register to access your personal account in the Learning Management Center. A one time registration process is required. Additional details are available at 46 Thank You for Participating! Please contact the ASCQR Support Contractor if you have any questions: Submit questions online through the QualityNet Question & Answer Tool at Or Call the ASCQR Support Contractor at This material was prepared by FMQAI, the Support Center for the Ambulatory Surgical Center Quality Reporting program, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). The contents presented do not necessarily reflect CMS policy. FL-10SOW-2014FS4T

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