(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 12
systems. For example, since 2005, we have applied the Hospital Inpatient Quality
Reporting (IQR) Program under the hospital inpatient prospective payment system.
Hospital IQR provides differential payments to hospitals that meet certain requirements,
including publicly reporting their performance on a defined set of inpatient care
performance measures. Beginning in 2007, under the physician fee schedule, we have
provided for quality measure reporting through the Physician Quality Reporting System,
which includes incentive payments for eligible professionals who satisfactorily report
data on quality measures for covered professional services furnished to Medicare
beneficiaries. In 2009, Congress passed the Health Information and Technology for
Economic and Clinical Health (HITECH) Act. As part of the Electronic Health Records
(EHR) Incentive Program under HITECH, we have defined measures for the meaningful
use of certified electronic health records technology and have developed incentive
payment programs for both Medicare and Medicaid providers. We have extended similar
efforts to additional payment systems, including the hospital outpatient prospective
payment system and various post-acute care systems.
In addition to improving quality, value-based purchasing initiatives seek to reduce
growth in health care expenditures. It is widely recognized that the trajectory for the
nation's health care spending is unsustainable. Medicare beneficiaries share in the burden
of rising costs, as they pay higher premiums, and larger cost-sharing obligations and outof-pocket
expenses. The Affordable Care Act includes a series of reforms expected to
significantly slow growth in the Medicare spending rate while simultaneously
strengthening the care provided to Medicare beneficiaries. These reforms build upon
existing value-based purchasing efforts currently underway within CMS to find ways to