ASA Seeks Greater Anesthesiologist Participation in APMs, Sustainability Teams

In a recent response to the proposed 2025 Inpatient Prospective Payment System (IPPS), ASA urged the Centers for Medicare & Medicaid Services (CMS) to expand opportunities for anesthesiologists to participate in alternative payment models (APMs). As leaders in perioperative care and care coordination, anesthesiologists would be essential to the successful implementation of CMS’s proposed Transforming Episode Accountability Model (TEAM). ASA opposes making alternative payment models mandatory and, if TEAM is finalized, our letter called for a voluntary, thoughtful roll out of the TEAM model over several years.

ASA also promoted the contributions anesthesiologists make to local sustainability efforts. Within the rule, CMS proposed a TEAM Decarbonization and Resilience Initiative that focused heavily on anesthetic gas use and several hospital-level initiatives aimed at reducing carbon emissions. ASA offered extensive recommendations for CMS to consider, recommending hospital sustainability teams include dedicated time and support for anesthesiologist participation. ASA also encouraged hospitals to reinvest savings from sustainability efforts in further actions that can reduce a hospital’s carbon footprint.

ASA comments cautioned against the implementation of two structural hospital-based measures related to patient safety and age friendly designations. Consistent with previous ASA positions, the structural measures as currently crafted either duplicate current regulatory requirements or may not have a direct relationship to enhanced patient safety initiatives or patient outcomes. Although the two structural measures include noble aims, further refinement of the measures is needed to protect against increasing physician administrative burdens.   

The 2025 IPPS proposed rule includes policy changes to hospital payments as well as hospital-level quality measures. CMS will consider submitted comments and release a final IPPS rule later this year for implementation in 2025.

Contact the ASA Department of Quality and Regulatory Affairs at [email protected] for further information.