“We—all of us—are currently delivering the safest, smartest, and most compassionate relief of suffering in the history of mankind,” declared Past President Michael Champeau, MD, addressing the ASA Board of Directors in Chicago on August 15. “The problem is that we have made anesthesia look so easy that its worth isn’t obvious. Some people seem to think we should be giving anesthesia—or giving it away—for next to nothing!”
Dr. Champeau spoke to the board as part of his campaign for ASA Assistant Treasurer. Currently, he serves as ASA Director from California, representing our state as a member of the ASA Board of Directors.
His campaign speech highlighted the threat to all anesthesiologists from the payment changes that will take place as the new Medicare Access and CHIP Reauthorization Act (MACRA) law is implemented over the next several years. Dr. Champeau believes that MACRA will have a greater day-to-day impact on our practices than the Affordable Care Act, and hopes to help anesthesiologists understand the new law and adapt their practices accordingly.
Other CSA officers and Executive Director David Butler also spent the weekend at the board meeting in Chicago, supporting Dr. Champeau’s campaign, meeting with ASA staff, and considering the issues that will be presented to the full House of Delegates at ASA’s upcoming annual meeting in October.The officers included CSA President James Moore, MD, President-Elect Mark Zakowski, MD, Speaker Christine Doyle, MD, Secretary Karen Sibert, MD, and Past Presidents Johnathan Pregler, MD, Mark Singleton, MD, and Paul Yost, MD.
Approving Quality Measures
One proposal certain to spark debate at the ASA House of Delegates' meetIng emanates from the Committee on Performance and Outcomes Measurement (CPOM), chaired by Dr. Moore. Traditionally, quality measure developed by CPOM have been submittted to the House of Delegates (HOD) for approval before they are sent to the National Quality forum (NQF) and the Centers for Medicare & Medicaid Services (CMS). However, the committee report noted that measures may be submitted to the NQF or CMS only at certain times during the year, most of which do not coincide with the HOD's annual October meeting. The wait for appproval at the HOD, or revisions requrested by the HOD, may result in significant delays.
Today, anesthesiologists face increasing pressure to report more quality outcome measures, yet only three reportable measures currently exist for anesthesia care: perioperative temperature management, prevention of central venous catheter-related bloodstream infections, and timing of prophylactic antibiotics.
“Creating and submitting viable new performance measures is critical,” the CPOM report stated. An inadequate number of quality measures can “increase the risk of either receiving a negative payment adjustment or failing to achieve a positive payment adjustment. CPOM is committed to ensuring that the measure development and submission process be as efficient as possible, so that ASA can help meet the needs of its members for federal quality reporting.”
The proposed change in procedure would notify the HOD and the general membership of any new outcome or performance measure, and allow review and comments for at least 30 days. After the review period, the Vice President for Professional Affairs would have authority to advance the new measure to the NQF directly. After a new measure is submitted to the NQF or another external entity, the HOD would not have further opportunity to debate it.
During the time before a new quality measure is submitted to the NQF, the House could debate it fully, adopt or reject it, or refer it back to committee. However, the content or wording of the measure would not be subject to amendment by the House.
Other Board Recommendations
The board heard testimony from ASA Directors and Alternate Directors for and against a number of other committee recommendations. The board recommended the following for approval:
- The creation of a Committee on Health and Public Policy, with funding of $250,000 to implement a MACRA action plan
- The creation of a new physician leadership educational collaboration with the Kellogg School of Management Executive Education Program
- That the Committee on Quality Management and Departmental Administration (QMDA) provide no further consultation services until the committee develops a revised proposal for consultation services and it is approved by the Administrative Council
- Revised policy and procedure documents
- Statement on Distractions
- Statement on Fatigue
- Statement on Documentation of Anesthesia Care
- Statement on Transesophageal Echocardiography
- That the Task Force on Environmental Sustainability be established as a standing ASA committee
We are fortunate to have three current ASA officers from California running unopposed this year. Daniel Cole, MD, ASA President-Elect, will succeed J.P. Abenstein, MD, as ASA President. Stan Stead, MD, MBA, will remain Vice President for Professional Affairs, and Linda Mason, MD, will continue to serve as Secretary.
Dr. Champeau has two opponents in the race for Assistant Treasurer, but the CSA and the entire Western Caucus believe that he is uniquely qualified for the job by virtue of his executive experience as former treasurer and president of the CSA. If you have friends or former colleagues in other parts of the country eligible to vote at the ASA House of Delegates, please encourage them to support Dr. Champeau!
The ASA annual meeting, ANESTHESIOLOGY® 2015, will kick off on Saturday, October 24 in San Diego. Please book your hotel room and register for the meeting now if you haven’t already. The CSA will host an evening reception in honor of Dr. Champeau, and we look forward to seeing you there!