(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 217
ACO would qualify for the Physician Quality Reporting System incentive as a group practice,
and not as individuals. In addition, we propose a calendar year reporting period from January 1
through December 31, for purposes of the Physician Quality Reporting System incentive under
the Shared Savings Program.
With regard to the requirements for satisfactory reporting for purposes of earning the
Physician Quality Reporting System incentive under the Shared Savings Program, we propose to
incorporate certain aspects of the criteria for satisfactory reporting under the 2011 Physician
Quality Reporting System GPRO I option (75 FR 73506), with a few modifications. In
particular, we propose the following criteria for satisfactory reporting for purposes of the
Physician Quality Reporting System incentive for the first performance period under the Shared
Savings Program:
• ACOs, on behalf of its EPs, would need to report on all measures included in the data
collection tool;
• Beneficiaries will be assigned to the ACO using the methodology described in the
Assignment section of this proposed rule. As a result, the GPRO tool would be populated based
on a sample of the ACO-assigned beneficiary population. ACOs would need to complete the
tool for the first 411 consecutively ranked and assigned beneficiaries in the order in which they
appear in the group's sample for each domain, measure set, or individual measure if a separate
denominator is required such as in the case of preventive care measures which may be specific to
one sex. If the pool of eligible assigned beneficiaries is less than 411, the ACO would report on
100 percent of assigned beneficiaries for the domain, measure set, or individual measure.
• The GPRO tool will need to be completed for all domains, measure sets, and measures
described in Table 1.