ACP Quality Measures

Advance care planning is being viewed as an increasingly important component in the delivery of patient-centered care, and as such, is being incorporated as a key quality measure in payment programs.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bipartisan legislation signed into law on April 16, 2015, which fundamentally changes the way that Medicare rewards clinicians for value over volume.  On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) released the final rule with comment period to implement MACRA’s new Quality Payment Program (QPP). The QPP has two tracks providers can choose from:

  • The Merit-Based Incentive Payment System (MIPS)
  • The Advanced Alternative Payment Models (APMs)

Providers who participate in MIPS will earn a performance-based payment adjustment. Providers who participate in an Advanced APM, through Medicare Part B, may earn an incentive payment for participating in an innovative payment model.

Most providers will initially participate in Medicare through MIPS.

Advance Care Planning Measure
CMS released 273 quality measures that eligible clinicians can report on for 2017. Advance care planning that leads to a plan of care for complex medical conditions (Measure #47 – NQF 326) is considered a high priority measure for many providers under MIPS.

The measure’s description is: “Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan.”

Learn more about the Quality Payment Program and Measure #47 here.