The Centers for Medicare and Medicaid Services (CMS) on July 3 released the Quality Measure Sets for Bundled Payments for Care Improvement (BPCI) Advanced Model Year 3, which qualifies as an Advanced Alternative Payment Model under the Quality Payment Program.

Participants selected for the second BPCI Advanced cohort will start Model Year 3 on Jan. 1, 2020.

Model Year 3 includes 33 voluntary inpatient episodes, including a new episode for TAVR, and four voluntary outpatient clinical episodes.

Under the program, participants can report the Administrative Quality Measures Set or a new Alternate Quality Measures Set, which consists of claims-calculated measures and clinical registry-calculated measures. All participants, regardless of whether they select the Administrative Quality Measure Set or the Alternate Quality Measure Set will be scored on two claims-calculated measures:

• Advance Care Plan (NQF #0326), derived from Quality Data Codes submissions
• All-Cause Hospital Readmissions (NQF #1789), derived from Inpatient Quality Reporting (IQR) Program performance

Participants using the Alternate Quality Measure Set will also report on select clinically-relevant measures for each episode. The ACC anticipates that the CathPCI Registry, Chest Pain – MI Registry and ICD Registry will be approved reporting options for those selecting the new Alternative Quality Measure Set for the following episodes:

• Acute Myocardial Infarction (AMI)
• 3-Item Care Transition Measure (NQF #0228)*
• Overall Defect Free Care (NQF #2377), currently reported in the Chest Pain – MI Registry
• Cardiac Defibrillator
• 3-Item Care Transition Measure (NQF #0228)*
• Discharge Medications: Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker and Beta-Blockers in Eligible Implantable Cardioverter-Defibrillator Implant Patients (Composite Measure) (NQF #0965), currently reported in the ICD Registry
• Hospital Risk-Standardized Complication Rate following Implantation of Implantable Cardioverter-Defibrillator, currently reported in the ICD Registry
• Percutaneous Coronary Intervention
• Cardiac Rehabilitation Patient Referral from an Inpatient Setting (NQF #0642), currently reported in the CathPCI Registry
• In-hospital Risk Adjusted Rate of Bleeding Events for Patients Undergoing PCI (NQF #2459), currently reported in the CathPCI Registry
• Therapy with Aspirin, P2Y12 Inhibitor, and Statin at Discharge following PCI in Eligible Patients (NQF #0964), currently reported in the CathPCI Registry

* This measure will be derived from IQR performance, not registry performance.

In addition, CMS is exploring modifications to the model to incentivize increased use of cardiac rehabilitation services for BPCI Advanced participants. Additional information will be released by CMS when available.

Participants must indicate their selected measure set for each clinical episode by November. Current BPCI Advanced participants and those who applied for Model Year 3 will receive more information from CMS regarding deadlines for episode and measure set selection.

Additional information about the Quality Measure Set is available on CMS.gov.

Keywords: Accountable Care Organizations, Subacute Care, Outpatients, Inpatients, Centers for Medicare and Medicaid Services, U.S., Transcatheter Aortic Valve Replacement, Group Practice, Physicians, Durable Medical Equipment, Cohort Studies, ACC Advocacy, National Cardiovascular Data Registries, CathPCI Registry, Chest Pain MI Registry, ICD Registry

< Back to Listings