Features  |   April 2015
Payment Models for the Perioperative Surgical Home
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Practice Management / Quality Improvement / Features
Features   |   April 2015
Payment Models for the Perioperative Surgical Home
ASA Monitor 04 2015, Vol.79, 30-31.
ASA Monitor 04 2015, Vol.79, 30-31.
While there is general consensus on the structure of a Perioperative Surgical Home (PSH) model and the types of services it will provide, there is less agreement on who will pay for those services or how those payments will be structured. At the ASA’s PRACTICE MANAGEMENT 2015 conference in Atlanta, a number of presentations centered on payment models. Although these talks did not exclusively address the PSH, much of the information presented can be applied to this model of care.
A PSH is primarily a method of organizing and delivering optimal medical care for the patient’s particular condition and co-morbidities, but it may also be considered an alternative payment model (APM). In fact, ASA intends to have the Centers for Medicare & Medicaid Services (CMS) recognize the PSH as an APM, which would provide two benefits: to validate a PSH as a payment mechanism and simplify quality reporting. Part of last year’s failed legislation to repeal the Sustainable Growth Rate (SGR) formula would have consolidated the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (VBPM) and Meaningful Use reporting requirements into the Merit-based Incentive Payment System (MIPS). The legislation proposed that physicians receiving a specified percentage of their income from APMs would be exempt from some of the MIPS requirements.
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