The Center for Medicare and Medicaid Services has published its final rule as part of its 2011 update to policies and payment rates for inpatient services furnished in hospitals.
CMS did not finalize a proposal requiring hospitals to report a quality measure that was generated from one of four registries. One of the proposed registries had been the ACC-NCDR ICD registry, which is the data repository for implantable cardioverter defibrillator (ICD) procedures. This registry is currently required for use for all Medicare patients receiving the service for primary prevention purposes as part of decision to provide coverage with evidence development.
The CMS decision not to finalize was partially based on opposition from hospitals that were concerned about costs of registries to hospitals. CMS will instead look to consider performance measures that may be determined by registries, but calculated through other means. Also, because CMS did not require a single registry measure (rather giving an option of four,) there would be no way to adjust payment for performance on these measures. CMS says it did not intend to require hospitals to have to participate in registries in which they do not already participate.
ACC continues to believe that registries offer opportunities to improve the care process in ways that measures based on chart abstraction do not. We will work with CMS to better understand ways that these important tools can receive the incentives that will increase their use in the Medicare population.