Sometimes eliminating a quality measure is more interesting than creating one.

In the proposed 2027 OPPS/ASC rule, CMS proposes removing the Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients measure from both the Hospital Outpatient Quality Reporting and ASC Quality Reporting programs beginning with the 2027 reporting period for the 2029 payment determination.

The measure is straightforward. After a normal colonoscopy in an average-risk patient, it looks for documentation recommending the appropriate 10-year follow-up interval. That sounds sensible. The problem is that healthcare can accumulate measures long after their ability to distinguish good performers from poor performers has diminished. CMS notes that another colonoscopy measure in the programs is more closely tied to clinical outcomes rather than simply documentation.

That distinction should interest every ASC administrator.

Quality reporting has a real financial consequence. An ASC that fails to satisfy ASCQR requirements can lose two percentage points from its annual Medicare payment update. Yet every measure also consumes administrative time. Someone has to extract the information, validate it, submit it and correct errors. Multiply that burden across thousands of cases and dozens of regulatory requirements and “just one more measure” is no longer free.

CMS is also asking whether its All-Cause Transfer/Admission measure should eventually be stratified by the phase of care in which the event occurs. That could become important. A transfer from an ASC during immediate recovery is operationally different from a hospital admission days later, and lumping the two together can obscure what actually happened.

The larger lesson is that quality measurement is slowly maturing from Did you document it? toward Did the patient actually do well?

Surgeons should welcome that evolution. A beautifully completed checkbox never cured a complication.