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Inside this edition:

Message from the President

I hope this finds you settled into the New Year and doing well. Have you registered yet for the TNACS Day on the Hill? This event on March 1 is a great opportunity to join with other surgeons and physicians to talk with state lawmakers about the biggest issues facing your practice and your patients. Please register today!

Mark your calendars for July 22-24, 2016, the TNACS Annual Meeting, Westin Beale Street, Memphis. ACS President David Richardson will be joining us for the meeting. Come learn the latest in surgical practice, quality improvement, National and TN payment reform. . .all the while earning self-assessment and CME credit. As always, fun will be part of the agenda, and a Redbirds game is on tap!

Finally, please take a moment to read the very important information included below!

Tennessee Surgical Quality Collaborative Launches QI Project to Prevent Post-operative Respiratory Complications

By Chris Clark, RN,

The Tennessee Surgical Quality Collaborative (TSQC) has identified post-operative respiratory complications as a quality improvement opportunity from the Tennessee Collaborative’s data. Key findings in the aggregate Tennessee data from the participating sites indicated that all pulmonary preoperative risk factors are significantly greater in Tennessee than nationally.
  • The prevalence of smoking in preoperative surgical candidates in Tennessee is nearly 50% higher than the national average at 27% compared to 18.2%.
  • The prevalence of chronic obstructive pulmonary disease is over 75% higher among Tennessee surgical candidates compared to national at 8.3% versus 4.7%. There are two-thirds more preoperative surgical candidates that are ventilator-dependent in Tennessee than nationally - 0.5% to 0.3%.
As a consequence of the additional preoperative pulmonary risk burden, the prevalence of postoperative pneumonia and unplanned intubation is 48% and 66% higher in Tennessee than nationally; adding $2,372,516 and $1,835,149 in postoperative health care costs, respectively.

The TSQC has selected the ICOUGHâ„  Program as the Collaborative’s project intervention for 2016.  ICOUGHâ„  was developed by the surgical staff at Boston Medical Center and has resulted in a 50% reduction in respiratory complications in their institution.

The acronym “ICOUGH℠” is a pulmonary care program that bundles care processes known to prevent pulmonary complications including early and frequent mobilization, lung exercises, oral hygiene, and education to reduce postoperative complications. The TSQC has partnered with Boston Medical Center’s NSQIP team as expert faculty and coaches to support the TSQC teams in implementing the ICOUGH℠ program. Five Tennessee hospitals piloted the ICOUGH℠ program in 2014/2015 and serve as local mentors to the other members of the collaborative.

"I think that all of us who practice surgery in Tennessee have an intuitive appreciation for the challenges we face with the pulmonary health of our patients. The ICOUGH℠” program is a simple but organized approach that can be applied to every surgical patient, and if applied diligently, it will lead to a measurable reduction in pulmonary complications within the next 2 years,” stated William Gibson, MD, FACS, Chair, TSQC Leadership Committee.

Register Now: 2016 Medicare Quality Reporting Programs

The Philadelphia Regional Office of the Centers for Medicare & Medicaid Services will be hosting a webinar entitled â€œThe Medicare Quality Reporting Programs: What Eligible Providers Need to Know in 2016” on Wednesday, February 17, from 11:30 AM – 1:00 PM EST. Topics that will be discussed include:
  • Medicare Access and CHIP Reauthorization Act (MACRA) Preview
  • 2016 Incentive Payments and 2018 Payment Adjustments
  • 2016 PQRS Updates
  • 2018 Value-based Payment Modifier (VM) Policies
  • Physician Compare Updates for 2016
  • Meaningful Use of CEHRT in 2016
The webinar will be delivered via WebEx, and instructions on how to join the call will be given upon registration.  To register, please see the link below:

Wednesday, February 17, 2016, 11:30 AM – 1:00 PM EST 

1.Go to
2. Click "Register".
3. On the registration form, enter your information and then click "Submit"

Once the host approves your registration, you will receive a confirmation email message with instructions on how to join the event.
For assistance
You can contact CMS OTS DENC at:

IMPORTANT NOTICE: This WebEx service includes a feature that allows audio and any documents and other materials exchanged or viewed during the session to be recorded. By joining this session, you automatically consent to such recordings. If you do not consent to the recording, discuss your concerns with the meeting host prior to the start of the recording or do not join the session. Please note that any such recordings may be subject to discovery in the event of litigation.

Important Notice From CMS

CMS Quality Measure Development Plan Supporting the Transition to the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs)

December 18

By: Kate Goodrich, M.D., M.H.S., Director, Center for Clinical Standards & Quality, CMS

Today we’re continuing to shift Medicare payments from volume to value by posting our draft Quality Measure Development Plan [].

The Measure Development Plan is a strategic framework for future clinician quality measurement development.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) further supports the path to value in health care with the new Merit-based Incentive Payment System (MIPS) and incentives for providers to participate in alternative payment models (APMs).

To accelerate the alignment of quality measurement and program policies, MACRA sunsets payment adjustments for three existing clinician reporting and incentive programs:
  • Physician Quality Reporting System (PQRS).
  • Value-based Payment Modifier (VM).
  • Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), commonly known as Meaningful Use.
The Measure Development Plan outlines how we’ll draw from our quality measure development experience to build a measure portfolio for MIPS and APMs. Existing measurement strategies, policies, and principles will guide our efforts.

The Measure Development Plan focuses on gaps we identified in the quality measure sets currently in use in PQRS, VM, and the EHR Incentive Program and offers recommendations for filling these gaps. Future measure development will prioritize person- and caregiver-centered experience of care, patient-reported outcomes and patient health outcomes, communication and care coordination, and appropriate use of resources across six quality domains:
  1. Clinical Care
  2. Safety
  3. Care Coordination
  4. Patient and Caregiver Experience
  5. Population Health and Prevention
  6. Efficiency and Cost Reduction
In addition, these measures will promote efficient data collection, better ensure provider accountability—individual and shared, and yield publicly reported quality results that consumers can use to make informed health care decisions.

The Measure Development Plan describes how CMS will work collaboratively with federal and state partners and private payers to create an aligned set of measures that reduces provider burden.  The plan also describes resources and activities that can contribute to the development of measures applicable to a wide variety of stakeholders.

As our portfolio of measures evolves, we will continue to seek input on the draft plan and its stated priorities from clinicians, payers, patients, caregivers, and other stakeholders. We’ll review and consider all comments we receive as we develop the final Measure Development Plan, which we will post by May 1, 2016.

The Measure Development Plan directly supports the implementation of MIPS and APMs and your input is important to us. These programs move the Medicare program and our overall health care system toward paying for the quality rather than the quantity of care delivered to patients.

We encourage you to read the Measure Development Plan and send us your comments, questions or thoughts by March 1, 2016, either online []; via the MDP dedicated email address []; or by U.S. mail [Attn: Eric Gilbertson, CMS MACRA Team; Health Services Advisory Group, Inc.; 3133 East Camelback Road, Suite 240; Phoenix, AZ 85016-4545].

Save the Date!

2016 TNACS Annual Meeting
July 22-24, 2016
Memphis, TN


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