(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 167
measures to assess the quality of care furnished by the ACO, such as measures of clinical
processes and outcomes; patient, and, wherever practicable, caregiver experience of care;
and utilization (such as rates of hospital admission for ambulatory sensitive conditions).
Section 1899(b)(3)(B) of the Act requires ACOs to submit data in a form and manner
specified by the Secretary on measures that the Secretary determines necessary for the
ACO to report in order to evaluate the quality of care furnished by the ACO. We believe
that the Secretary's authority to determine the form and manner of data submission allows
for establishing requirements for submission of data on measures the Secretary
determines to be appropriate for evaluating the quality of care furnished by the ACO,
without regard to whether the Secretary has established a specific quality performance
standard with respect to those measures that must be met in order to be eligible for shared
savings.
We propose that an ACO be considered to have met the quality performance
standard if they have reported quality measures and met the applicable performance
criteria in accordance with the requirements detailed in rulemaking for each of the three
performance years. We further propose to define the quality performance standard at the
reporting level for the first year of the Shared Savings Program and to define it based on
measure scores in subsequent program years. We have listed the measures we propose to
use to establish quality performance standards that ACOs must meet for shared savings
for the first performance period in Table 1. Quality measures for the remaining two years
of the 3-year agreement will be proposed in future rulemaking.
b. Considerations in Selecting Measures
We view value-based purchasing as an important step to revamping how care and