ASC Quality Reporting
The Ambulatory Surgical Center Quality Reporting (ASCQR) Program is a pay-for-reporting, quality data program finalized by the Centers for Medicare & Medicaid Services (CMS). Under this program, ASCs report quality of care data for standardized measures to receive the full annual update to their ASC annual payment rate, beginning with Calendar Year (CY) 2014 payments.
Initial program requirements were included in the CY 2012 Outpatient Prospective Payment System (OPPS)/ASC final rule, CMS-1525-FC, and the FY 2013 Inpatient Prospective Payment System (IPPS) rule.
ASC Quality Reporting Measures
The Centers for Medicare & Medicaid Services (CMS) seeks to develop a comprehensive set of quality measures to be available for widespread use for making informed decisions and quality improvement in the ambulatory surgical center (ASC) setting. For the CY 2020 payment determinations, a variety of data sources were used to determine the quality of care that Medicare beneficiaries received, including measures submitted via a web-based tool and Quality Data Codes placed on the CMS claim form, both completed by the facility, or through Medicare administrative claims information.
CMS continues to evaluate measures, ensuring meaningful information is collected to ensure quality of care, removing measures that are no longer needed and adding measures to continue the quality improvement process. Measures planned for future implementation will focus on intraoperative and post-operative care.
Measures for the CY 2020 Payment Determination
- ASC-1 Patient Burn
- ASC-2 Patient Fall
- ASC-3 Wrong Site, Wrong Side, Wrong Patient, Wrong Procedure, Wrong Implant
- ASC-4 All-Cause Hospital Transfer/Admission
- ASC-9 Endoscopy/Polyp Surveillance: Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients
- ASC-10 Endoscopy/Polyp Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous Polyps – Avoidance of Inappropriate Use
- ASC-11 Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery*
- ASC-12 Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy
- ASC-13 Normothermia
- ASC-14 Unplanned Anterior Vitrectomy
* ASCs may voluntarily submit data for CY 2018 but will not be subject to a payment reduction with respect to this measure during the voluntary reporting period.
** Does not require any additional data submission apart from standard Medicare Fee-for-Service claims.
In selecting measures for the ASC Quality Reporting Program, we have focused on measures that have a high impact on and support HHS and CMS priorities for improved health care outcomes, quality, safety, efficiency and satisfaction for patients. Our goal for the future is to expand any measure set adopted for ASC quality reporting to address these priorities more fully and to align ASC quality measure requirements with those of other reporting programs as appropriate, including the Hospital Outpatient Quality Reporting Program, the Hospital Inpatient Quality Reporting Program, Physician Quality Reporting System (PQRS), and reporting requirements implemented under the HITECH Act so that the burden of reporting will be reduced.
Check this page periodically for new updates and announcements about the ASCQR Program.