The Centers for Medicare & Medicaid Services (CMS) formally approved a new quality measure developed by the Quality Team at North American Partners in Anesthesia (NAPA) for the Anesthesia Business Group (ABG) Qualified Clinical Data Registry (QCDR). This measure, which is eligible for data collection and submission for the 2025 payment year, aims to reduce pulmonary aspiration in high-risk gastric distension patients who undergo anaesthesia, including symptomatic patients taking GLP-1 receptor agonist medications. As a leader in anaesthesia care and patient safety, NAPA is at the forefront of improvements related to patient safety challenges such as this.
"The inclusion of NAPA's quality improvement measure in the CMS QPP MIPS program exemplifies our commitment to patient safety and innovation," said Dr Rafael Cartagena, NAPA CEO, emphasized NAPA leadership in advancing anaesthesia safety. "Through collaboration with the ABG, Graphium Health, CMS, and our clinical partners, we continue to set the standard for reducing harm in anaesthesia care. NAPA is proud to be an innovator in the anaesthesia community."
Through its NAPA Anesthesia Patient Safety Institute (NAPSI) - an AHRQ-certified component Patient Safety Organization - NAPA developed and implemented a performance improvement measure to reduce the incidence of pulmonary aspiration in high-risk patients based on evidence-based strategies. This measure was successfully implemented in June 2024 throughout clinical sites serviced by NAPA anaesthesia clinicians. The NAPA Quality team then collaborated with the ABG QCDR, administered by Graphium Health, to submit this measure to CMS for inclusion in the 2025 Quality Payment Program (QPP) MIPS track as "ABG 45: Aspiration Prevention in Patients with Gastric Distension."
The "Multi-society Clinical Practice Guidance for the Safe Use of Glucagon-like Peptide-1 Receptor Agonists in the Perioperative Period" was jointly released in October 2024 by the American Society of Anesthesiologists (ASA), the American Gastroenterological Association, the American Society for Metabolic and Bariatric Surgery, the International Society of Perioperative Care of Patients with Obesity, and the Society of American Gastrointestinal and Endoscopic Surgeons. The intent was guidance for perioperative clinicians related to the care and management of patients taking GLP-1 receptor agonists such as Mounjaro, Ozempic, and Wegovy for diabetic blood sugar control and weight loss.
Their guidance arose from the known delayed gastric emptying effects of these medications, which can result in residual gastric contents on the day of the procedure, despite adherence to traditional fasting regimens. Numerous case reports have been published regarding pulmonary aspiration of retained gastric contents in this patient population undergoing procedural sedation and anaesthesia.
Consistent with the multi-society guidance on GLP-1 receptor agonists, the new MIPS measure, ABG 45, specifically targets interventions for symptomatic gastric distension patients taking GLP-1 receptor agonists, as well as other high-risk gastric distension patients such as those with bowel obstruction, ileus, or incarcerated hernias.
This new CMS measure is the latest addition to a series of six clinical quality measures developed by NAPA in collaboration with the ABG QCDR. By pioneering these initiatives, NAPA reinforces its role as a leader in improving perioperative care and supporting its clinicians with tools to deliver exceptional outcomes.
Comments