CMS has proposed changes to certain ACO quality performance measures for 2019.

Two Patient Experience of Care Survey measures that are currently collected for informational purposes only under the CAHPS survey will now be scored and included in ACO quality score determination in 2019. The two measures that will be added are:

  1. Helpfulness, Courtesy and Respectfulness of Office Staff
  2. Care Coordination – Provider Access to Beneficiary Information and Provider Follow-Up

CMS also proposes to reduce the total number of measures in the quality measure set. More attention will be given to outcome measures and more process measures will be discontinued. The measures that are proposed to be retired are:

  1. Skilled Nursing Facility 30-Day All-Cause Readmission Measure
  2. All-Cause Unplanned Admissions for Patients with Diabetes
  3. All-Cause Unplanned Admission for Patients with Heart Failure
  4. Use of Imaging Studies for Low Back Pain

The measure will be retired from contributing to ACO quality measure scores, but will still be used to provide information to ACOs on their performance in those areas.

ACOs will also not be responsible for reporting the following measures in performance year 2019:

  • Medication Reconciliation Post-Discharge
  • Falls: Screening for Future Fall Risk
  • Pneumonia Vaccination Status for Older Adults
  • BMI Screening and Follow-Up
  • Diabetes Eye Exam
  • IVD: Use of Aspirin or another Antithrombotic

In addition, a new quality measure will be added for Quality Payment Program purposes:

  • Falls: Screening, Risk-Assessment, and Plan of Care to Prevent Future Falls