Quality in Otolaryngology
Through our mission statement, "Working for the Best Ear, Nose, and Throat Care," AAO-HNSF has prioritized the delivery of the highest quality healthcare to our patients as our core mission. But what does that really mean and how can the Foundation support its members in providing the highest quality care in daily practice?
Clinical Practice Guidelines
Clinical Practice Guidelines (CPGs) are a key metric to quality health care. The AAO-HNSF guideline development process has evolved since the first CPG published in 2004. CPGs provide actionable recommendations based on the current evidence. For a list of current CPGs and more information, visit this page.
Some of our earliest measure development efforts began with measures developed utilizing our CPGs. These measures were developed in conjunction with the AMA Physician Consortium for Quality Improvement (PCPI). Acute Otitis Externa (AOE), Otitis Media with Effusion (OME) and Adult Sinusitis measures were the outcome of these projects. In 2012, we developed measures groups to be utilized in the former PQRS program. Measures groups were formed from the Adult Sinusitis and AOE measures and became published groups for CMS. In 2015, the AAO-HNSF assumed stewardship of Sinusitis and Acute Otitis Externa measure sets developed by the PCPI. In 2017, the AAO-HNSF developed 18 specialty specific measures to address the need for specialty measures for MIPS reporting. New AAO-HNSF’s stewarded measures are available for use in the CMS Merit-based Incentive Payment System (MIPs) by participating in Reg-entsm the Foundation ’s Qualified Clinical Data Registry (QCDR). The Foundation continues to work through the Clinical Advisory Committees (CACs) to identify Otolaryngology-Head and Neck Surgery-specific topics for quality measure development.
The Academy’s 2017 measure development projects focused on the following measure topics: otitis media with effusion, cerumen impaction, age-related hearing loss, allergic rhinitis, Bell’s palsy tympanostomy tubes, neurotology, dysphonia, and rhinoplasty. Completed measures were submitted to the Centers for Medicare & Medicaid Services (CMS) for use in the Reg-entsm QCDR for the 2018 performance year. In addition, Overuse of Antimicrobials for OME (QPP 464), was accepted to CMS’ Quality Payment Program for use in 2018. For a full list of available 2018 Reg-entsm measures, please visit this page.
Reg-entsm ENT Clinical Data Registry
Data is a critical component in today’s ever-changing healthcare environment. The Reg-entsm registry harnesses the power of data to guide the best ENT care. Reg-entsm, focused on quality improvement and patient outcomes, is an essential tool that advances outcomes in the specialty. It serves as the foundation for Merit-based Incentive Payment System (MIPS) reporting, measures development, research, and contribute to Maintenance of Certification requirements. Whether you are a practitioner in small or large private practice or are employed by a academic medical system or hospital-based health system, the Reg-entsm registry has many benefits and services to offer. Reg-entsm is becoming the foundation in the specialty for defining quality, quality improvement, clinical and product research, and supporting maintenance of certification and licensure requirements. The first phase of Reg-entsm was to assist our members with public quality reporting, but the model is now expanding to fill these other needs of the specialty.
Reg-ent benefits the practice of Otolaryngology by:
- Safeguarding the role of otolaryngologist-head and neck surgeons in defining the best care
- Demonstrating the value of services provided by otolaryngologist-head and neck surgeons in all iterations of future payment models and providing the opportunity for participation in future private payer quality programs
- Serving as the first national data repository of otolaryngology specific data that may be mined for research purposes
- Helping define and develop otolaryngology specific quality measures
The Reg-entsm dashboard:
- Creates a visual representation of participant data, providing benchmark comparison to peers within a practice and nationally
- Provides the tools to monitor a practice and the outcomes of their patients
- Streamlines reporting for all performance categories of MIPS, including Quality, Advancing Care Information, and Improvement Activities.
Quality Payment Program
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) and established the Quality Payment Program (QPP). The
QPP includes two new physician payment tracks:
1) The Merit-based Incentive Payment System (MIPS), comprised of four reporting categories –
Quality Advancing Care Information, Improvement Activities, and Cost --
are calculated in aggregate to create a composite score to determine physician payments, or;
2) Alternative Payment Models (APMs) incorporate quality and total cost of care into physician payments.
Visit the AAO-HNS Quality Payment Program Advocacy page for more information, including AAO-HNS educational resources on the Quality Payment Program (QPP).
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