The Centers for Medicare and Medicaid Services (CMS) on Aug. 18 released quality measure sets for Model Year 4 of the Bundled Payments for Care Improvement (BPCI) Advanced program. BPCI Advanced qualifies as an Advanced Alternative Payment Model under the Quality Payment Program. Under the program, participants can continue to report the Administrative Quality Measures Set or a new Alternate Quality Measures Set, which consists of claims-calculated measures and clinical registry-calculated measures.

The ACC is pleased to announce that CMS has included several NCDR measures as part of the Alternate Quality Measures Set for acute myocardial infarction, cardiac defibrillator (inpatient or outpatient), and PCI (inpatient or outpatient) clinical episodes. The collaboration between CMS and the ACC to link the NCDR measures to the BPCI Advanced program reflects a shared interest in ensuring that new value-based payment models for cardiovascular care use clinically relevant and actionable quality measures.

Model Year 4 includes 31 voluntary inpatient episodes and four voluntary outpatient clinical episodes. Participants in the second BPCI Advanced cohort will start Model Year 4 on Jan. 1, 2021. At this time, CMS is not accepting new model applicants. All participants, regardless of whether they select the Administrative Quality Measure Set or the Alternate Quality Measure Set will be scored on two claims-calculated measures:

• Advance Care Plan (NQF #0326), derived from Quality Data Codes submissions
• Hospital-Wide All-Cause Unplanned Readmission Measure (NQF #1789), derived from Inpatient Quality Reporting (IQR) Program performance

Participants using the Alternate Quality Measure Set will also report on select clinically relevant measures for each episode.

ACC's CathPCI Registry, Chest Pain – MI Registry and ICD Registry are approved reporting options for participants using the new Alternative Quality Measure Set for the following episodes:

• Acute Myocardial Infarction (AMI)
• 3-Item Care Transition Measure (NQF #0228)*
• Overall Defect Free Care (NQF #2377), as currently reported in the Chest Pain – MI Registry
• Cardiac Defibrillator (Inpatient or Outpatient)
• 3-Item Care Transition Measure (NQF #0228)*
• Discharge Medications: Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker and Beta-Blockers in Eligible Implantable Cardioverter-Defibrillator Implant Patients (Composite Measure) (NQF #0965), as currently reported in the ICD Registry
• Hospital Risk-Standardized Complication Rate following Implantation of Implantable Cardioverter-Defibrillator, as currently reported in the ICD Registry
• Percutaneous Coronary Intervention (PCI) (Inpatient or Outpatient)
• Cardiac Rehabilitation Patient Referral from an Inpatient Setting (NQF #0642), as currently reported in the CathPCI Registry
• In-hospital Risk Adjusted Rate of Bleeding Events for Patients Undergoing PCI (NQF #2459), as currently reported in the CathPCI Registry
• Therapy with Aspirin, P2Y12 Inhibitor, and Statin at Discharge following PCI in Eligible Patients (NQF #0964), as currently reported in the CathPCI Registry

* This measure will be derived from IQR performance, not registry performance.

Model participants will have the opportunity to amend their Participant Agreements for each clinical episode this fall to reflect their choice of measure set. Participants must select either Administrative or Alternate Quality Measures Set for each clinical episode; however, they are not required to select the same Quality Measure Set across all clinical episodes. Current BPCI Advanced participants will receive further information from CMS regarding deadlines for episode and measure set selection through their BPCI Participant Portal.

Additional information about the Alternate Quality Measures Set will be made available on CMS.gov and on ACC's APM Hub.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Invasive Cardiovascular Angiography and Intervention, Implantable Devices, SCD/Ventricular Arrhythmias

Keywords: Centers for Medicare and Medicaid Services, U.S., Cardiac Rehabilitation, Percutaneous Coronary Intervention, Quality Indicators, Health Care, Outpatients, Patient Transfer, Inpatients, Defibrillators, Implantable, Medicare, Patient Readmission, Medicaid, Registries, Episode of Care, ACC Advocacy, National Cardiovascular Data Registries, CathPCI Registry, Chest Pain MI Registry, ICD Registry

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