AUA & the 2007 PQRI CAPU Lunch May 22, 2007 Anaheim, California

1. AUA & the 2007 PQRICAPU LunchMay 22, 2007Anaheim, California Robin Hudson, MPA Senior Manager of Quality Initiatives & Health Policy

2. What is the AUA Doing to Prepare Urology Practices for the 2007 PQRI?

3. AUA PQRI Toolkit • We want to make it as easy as possible for urologists who wish to participate • Working on toolkit including checklists and documentation suggestions • Warning: current specs on CMS PQRI website for antibiotic timing are not final!

4. AUA PQRI Webinar • It’s free! • Mark your calendars – June 5; 8 to 9:30 p.m. eastern • Presentation will be available after June 5 for replay if you can’t participate on that date • Register at www.AUAnet.org/calendar

5. CMS 2007 PQRIMeasures Applicable to Urology Perioperative care: • Timing of antibiotic prophylaxis – ordering physician • Discontinuation of prophylactic antibiotics (non-cardiac procedure) • Venous thromboembolism (VTE) prophylaxis

6. CMS 2007 PQRIMeasures Applicable to Urology Urinary Incontinence: • Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older • Characterization of Urinary Incontinence in Women Aged 65 Years and Older • Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

7. CMS 2007 PQRI Perioperative Care: Timing of Antibiotic Prophylaxis - Ordering Physician • Description • Percentage of surgical patients aged 18 years and older undergoing procedures with the indications for prophylactic parenteral antibiotics, who have an order for prophylactic antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required)

8. CMS 2007 PQRI Perioperative Care: Discontinuation of Prophylactic Antibiotics (Non-Cardiac Procedures) • Description • Percentage of non-cardiac surgical patients aged 18 years and older undergoing procedures with the indications for prophylactic antibiotics AND who received a prophylactic antibiotic, who have an order for discontinuation of prophylactic antibiotics within 24 hours of surgical end time

9. CMS 2007 PQRI Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) • Description • Percentage of patients aged 18 years and older undergoing procedures for which VTE prophylaxis is indicated in all patients, who had an order for Low Molecular Weight Heparin (LMWH), Low-Dose Unfractionated Heparin (LDUH), adjusted-dose warfarin, fondaparinux or mechanical prophylaxis to be given within 24 hours prior to incision time or within 24 hours after surgery end time

10. CMS 2007 PQRI Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older • Description • Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

11. CMS 2007 PQRI Characterization of Urinary Incontinence in Women Aged 65 Years and Older • Description • Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence whose urinary incontinence was characterized at least once within 12 months

12. CMS 2007 PQRI Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older • Description • Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months

13. Should You Participate in PQRI? • Costs will likely exceed bonus payment – at least this year • Think in terms of clinical research trials – it takes time and practice to become efficient

14. Other AUA Quality Initiatives • Private payers • 2008 & beyond

15. AUA & Private Payers • Many private payers have programs • Mostly primary care measures right now • AUA will help members with private payer programs

16. AUA Measure Activity • Refinement of measures to include more urology codes in 2007 • Developing prostate cancer measures through the AMA Physician Consortium for Performance Improvement for 2008 quality reporting program • Establishing process to choose next diseases to work on going forward

17. Prostate Cancer Measure Testing • AUA is looking for urology practices to test prostate cancer measures • If interested, contact Rick Rutherford, AUA Practice Management Director, at rrutherford@auanet.org

18. AUA P4P Workgroup Representatives from: • Health Policy Council • Quality Improvement & Patient Safety Committee • Practice Guidelines Committee • Practice Management Committee • Education Council • Coding & Reimbursement Committee

19. AUA P4P Workgroup • Developed strategic plan and budget • Meets regularly to discuss P4P issues because they cut across all Health Policy departments

20. AUA Activities to Prepare You For P4P • Coming soon…. • P4P white paper • CMS proposed rule on 2008 quality program due on August 15 – look for AUA information and opportunity to weigh in on AUA comments!

21. Questions About Quality Initiatives? • Feel free to contact me at rhudson@auanet.org or 410-689-3762 • Thank you!! • Any questions??