The AANA continues to develop informational sources to aid certified registered nurse anesthetists (CRNAs) in understanding the complex relationship between quality and value outlined in many of the Center for Medicare and Medicaid Services (CMS) quality initiatives.  As these quality initiatives will affect reimbursement, it is important for CRNAs to build their knowledge base and become more familiar with some of these programs.  This website is intended to be an educational guide to the programs the AANA believes will impact CRNAs the most.  

 2017 MIPS Reporting

Medicare Access & CHIP Reauthorization Act (New Quality Payment Program)
Merit-based Incentive Payment System (MIPS) Performance Category Fact Sheets:

 Improvement Activities

Advancing Care Information  (optional for CRNAs) 
 ​Cost (no action required)​
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Alternative Payment Models
​Fact Sheets:

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2017 QCDR List (Anesthesia) - New!


2017 CMS Qualified Registry List




October 13, 2017-The Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, LLC, will be conducting field testing for eight episode-based cost measures before consideration of their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program. The field testing of new cost measures is separate from measures reported in the Quality and Resource Use Reports (QRURs), which you may also be receiving around the same time.  Field testing will take place from October 16 to November 15, 2017. During this time, CRNAs and clinician groups (TINs) who are attributed episodes for performing or managing certain procedures/medical conditions will have the opportunity to view a confidential report with information about their performance. In addition, all stakeholders will be able to view a mock report and supplemental documentation on the measures that will be publicly posted. CRNA feedback on the measures, confidential or mock report, and supplemental documentation can be made through an online survey (accessible 10/16/17). 
New Qualifying APM Participant Look-Up Tool
October 5, 2017-CMS has announced the results of the first Qualifying APM Participant (QP) determinations based on eligible clinician participation in the 2017 Advanced Alternative Payment Models (APMs). We have unveiled an interactive look-up tool where many 2017 Advanced APM participants can look up their QP status based on calculations from claims with dates of service between 1/1/17 and 3/31/17 for the first QP snapshot. Under the Quality Payment Program, eligible clinicians who meet certain criteria are considered QPs in Advanced APMs, and are therefore excluded from the MIPS quality reporting program. QPs identified based on the 2017 performance year will  receive a 5 percent lump sum Medicare incentive payment in 2019. The tool will be updated soon with calculations from claims with dates of services between 1/1/17 and 6/30/17.  The Methodology Fact Sheet is an excellent resource to understand how we determine QP Status. In addition, the supplemental service payments fact sheet, which reflects the supplemental service payments included in our APM Incentive Payment calculations, is now available.

2016 Annual QRUR Webcast-October,19, 2017 
October 4, 2017-CMS has made the 2016 Annual Quality and Resource Use Reports (QRURs) available to all group practices and solo practitioners nationwide. This event provides an overview of the report and explains how to interpret and use the information. 2016 Annual QRURs show how groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value-Based Payment Modifier (Value Modifier) and how the Value Modifier will be applied to payments for physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists. Learn more on the 2016 QRUR and 2018 Value Modifier webpage. This event will be more meaningful if you have your report in front of you to follow along. Visit How to Obtain a QRUR to access your report prior to the event.  Register for this Medicare webcast today!
MIPS Participation Status Look Up Tool 
July 27, 2017 - The Centers for Medicare and Medicaid Services (CMS) has recently introduced new information on qpp.cms.gov that indicates whether clinicians have “special  status” as determined by the rules in the Quality Payment Program for MIPS. Under MIPS, CMS makes “special status” determinations based on whether you are in a small practice, a non-patient facing clinician, hospital-based clinician, or practice in a health professional shortage or rural area.  To check your MIPS participation status with this new information, CRNAs should input their National Provider Identifier (NPI) into the MIPS participation status look up tool.  If you have questions about your MIPS status, please email qpp@cms.hhs.gov or call 1-866-288-8292.
2017 Complete CMS Approved QCDR List
June 15, 2017 - CMS recently released the much awaited Qualified Clinical Data Registry List.  These entities have self-nominated and demonstrated that they meet the applicable requirements outlined by CMS at 42 CFR §414.1400 and in the CY 2107 Quality Payment Program final rule with comment period.   Individual MIPS clinicians and groups wishing to submit MIPS data via a QCDR for the 2017 performance period are encouraged to review the list below before making a selection.  Each of the 2017 QCDRs has provided detailed information, including their contact information, the measures, activities, and performance categories they support, services offered, and costs incurred by their clients.  View the 2017 QCDR List today!

Notification of MIPS Participation Status 
April 26, 2017 - Beginning in late April 2017 Medicare Administrative Contractors (MACs) will send clinical group practices and individual clinicians a Participation Letter notifying them whether they will be included in the Merit-based Incentive Payment System (MIPS) Program. The Participation Letter includes an attachment indicating which clinicians under the group Tax Payer Identification Number (TIN) will have to report to MIPS based on the MAC's review of clinicians Medicare Part B reimbursement claims.  Clinicians who bill more than $30,000 in Medicare Part B services and who provide care to more than 100 Part B beneficiaries in the 2017 performance year are strongly encouraged to participate in the MIPS Program to avoid a 4% reduction in their Medicare 2019 reimbursements.  For more information on these letters please go to the FAQs page and visit the QPP website  for more information on the MIPS Program.  

2017 MIPS Measure Specifications Released
December 29, 2016 - The Centers for Medicare & Medicaid Services (CMS) has released the final specifications for the 2017 MIPS measures on December 29, 2016.   To view the measure specifications please visit CMS’ Quality Payment Program website under Education and Tools -> https://qpp.cms.gov/resources/education  These measure specifications can only be used for claims or qualified registry reporting only.  
2015 PQRS Performance Scores Posted on Physician Compare

December 20, 2016 - The Centers for Medicare & Medicaid Services (CMS) has released new performance data on the Physician Compare website. The 2015 data release includes individual clinician-level PQRS measures collected via claims and registry and non-PQRS Qualified Clinical Data Registry (QCDR) as well as group practice-level PQRS measures. You can visit the Physician Compare website to see if your performance scores have been publicly reported. For more information, you can also read our FAQ page on CMS Quality Public Reporting.  


 Educational Opportunities

CMS Quality Reporting for ASCs-Free Webinar
The Ambulatory Surgery Center Association (ASCA) will be hosted a free webinar on Tuesday, November 15, at 12:00 pm CST. Donna Slosburg, RN, BSN, LHRM, CASC, executive director of the ASC Quality Collaboration, and Gina Throneberry, RN, MBA, CASC, CNOR, director of education and clinical affairs for ASCA, will review which quality measures you need to report in 2017 and how you can meet all of the reporting requirements. Nursing contact hours and AEU credit are available. Click here to access the recording.

Transforming Clinical Practice Continuing Medical Education Module Available
A new Continuing Medical Education (CME/CE) module is now available for the health care provider community as part of CMS’ ongoing education and outreach efforts to inform providers about the latest initiatives of the Affordable Care Act.
Release/Duration: Posted on 9/19/2016. Expires on 9/19/2017.

CMS MLN Connects Call - 2016 PQRS Reporting: Avoiding 2018 Negative Payment Adjustments Call
On April 21, 2016, CMS hosted a live educational call, which provided an overview of the 2016 PQRS and related resources and covered guidance and instructions on how individual eligible professionals and PQRS group practices can get started, satisfactorily report/participate, and avoid the 2018 PQRS negative payment adjustment. The presentation slides are available through the CMS website. 

2016 PQRS Essentials for CRNAs - Archived Webinar 
This live webinar took place on April 14, 2016. Click here to download the presentation slides and video recording (login required).

 Contact Information

American Association of Nurse Anesthetists 
Research and Quality Division
Telephone: (847) 655-1170
DISCLAIMER: The information provided on the programs below was created by the AANA Research and Quality Division.  While we have made reasonable efforts to ensure the accuracy of the information, the rules and regulations that govern the programs may change. The AANA makes no legal representations regarding the rights and responsibilities of eligible providers/clinicians and shall not be held liable for any information presented here or on any third-party page linked to this website.  It is the responsibility of the reader to verify the accuracy of any statements made herein with the Centers for Medicare and Medicaid. 

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