ASA Promotes the Perioperative Surgical Home to House Subcommittee
Wed, May 2, 2018

On April 26, the American Society of Anesthesiologists submitted a formal communication to the House Ways and Means Committee Subcommittee on Health suggesting the Perioperative Surgical Home (PSH) as an innovative practice model in health care.  This letter was submitted in response to the Subcommittee's request for information in conjunction with a hearing on April 26 on "Innovation in Health Care." 

In the letter, ASA comments that physician anesthesiologists have been at the forefront of team-based, collaborative care for decades, so as healthcare transitions from an emphasis on volume and the importance of teamwork becomes more crucial, this role will be especially key.  The PSH model is a patient‐centric, team‐based system of coordinated care that guides patients through the entire surgical experience, from the decision to undergo surgery to discharge and beyond, with the goal of providing cost‐effective, high quality perioperative care and exceptional patient experiences.

In the comments, ASA shares the ongoing recognition of the PSH, including inclusion by the Centers for Medicare and Medicaid Services (CMS)' Medicare Quality Payment Program Final Rule for 2018 under the 2018 Merit-based Incentive Payment System (MIPS), the first time that the PSH model was recognized by CMS.  ASA also shared several of the practice improvements of PSH pilots including cost savings, reductions in lengths of stay, and reductions in readmission rates. These outcomes demonstrate that the PSH is a viable and effective care model that can be incorporated into institutions of any size and for a wide variety of procedures and modalities.  ASA also discussed the PSH Learning Collaboratives that have been established in conjunction with Premier, Inc, including plans for the next Collaborative in 2020.

As the PSH model is aligned with the ongoing shift from volume to value, ASA recommends that CMS recognize the PSH model as an innovative delivery care model that could be employed to achieve the goals of any surgical based Advanced Alternative Payment Model.  ASA will continue to advance the PSH as an innovative practice model and look forward to working with the Committee on this effort.

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