Editorial  |   February 2014
Measuring Performance
Author Affiliations
  • N. Martin Giesecke, M.D.
    ASA NEWSLETTER
    Editor
Article Information
Practice Management / Quality Improvement / Editorial
Editorial   |   February 2014
Measuring Performance
ASA Monitor 02 2014, Vol.78, 4-5.
ASA Monitor 02 2014, Vol.78, 4-5.
“What Got You Here Won’t Get You There” is the title of a 2007 publication of Marshall Goldsmith, Ph.D. Dr. Goldsmith is a world-renowned executive trainer and coach. Even though Dr. Goldsmith’s typical audience is composed of movers and shakers in the business world, his words ring true in medicine. As the measurement of anesthesiology performance and outcome continues to evolve, it is clear that what brought us where we are, as physicians and anesthesiologists, will not take us where we need to go, while remaining in the same profession – at least from a payment point of view.
As described by Drs. Fleisher and Cole in their article “PQRS: At the Intersection of Quality Improvement and Consumerism” (see page 16 in this NEWSLETTER), the practice of anesthesiology has already begun to be measured by Medicare. Originally, the three Medicare measures – patient temperature within 30 minutes of the end of surgery, appropriate timing of preoperative I.V. antibiotics, and central venous catheter insertion management – allowed anesthesiology practitioners (or groups) to receive a small incentive from Medicare. These three measures are just a few of the more than 300, applying to all medical specialties, that are reviewed by Medicare. The more important aspect is that as of 2015, the incentive that has been paid to participate (by meeting the measures) will actually become an amount of payment Medicare withholds from those who either don’t participate or who don’t meet the performance metrics. In 2015, that payment adjustment will be 1.5 percent. In 2016, for those whose reports fail to meet the metric, the Medicare value-based adjustment will be 2.0 percent.
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