1. Qualified Clinical Data Registries A new mechanism to report physician performance CMS will phase out claims-based reporting in favor of this registry- based mechanism over the next 5 years Moves responsibility for measure development, data collection and reporting from CMS to the specialty society registry Will allow the society to select and develop its own measures NACOR is one of the first registries certified under this program 19 measures have been approved for the first year – we will have the option of adding to or removing from this list in 2015

2. Anesthesia Measures in the QCDR 4 existing PQRS measures (antibiotic timing, central line sterile placement, PACU normothermia, beta blockade for CABG patients) Also from PQRS: Medication reconciliation (#130) Smoking cessation screening (#226) Acute pain management (#342) Preoperative risk assessment (#358)

3. Anesthesia Measures in the QCDR (cont.) Post-op transfer of care protocol OR > PACU Post-op transfer of care protocol OR > ICU Prevention of PONV, adults Prevention of PONV, pediatrics OR/PACU cardiac arrest rate OR/PACU all-cause mortality Successful completion of planned procedure (composite anesthesia safety)

4. Anesthesia Measures in the QCDR (cont.) PACU re-intubation rate PACU acute pain management success Composite procedural safety for central line placement Composite anesthesia patient satisfaction

5. How to Participate Practices/providers must self-nominate to CMS by July 1 Practices must participate in NACOR Discount to $0 for ASA members; no charge for QCDR reporting in 2014 $500 per year for non-members; additional charges for QCDR reporting may apply Practices must report NPI numbers to NACOR for eligible providers Practices must collect and report the necessary performance measures through either billing data or QM data systems