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New CMS Quality Measure Focused on GLP-1 and Pulmonary Aspiration

In a significant step towards enhancing patient safety, the Centers for Medicare & Medicaid Services (CMS) have officially approved a new quality measure developed by North American Partners in Anesthesia (NAPA). This measure is aimed at minimizing risks associated with pulmonary aspiration during anesthesia in high-risk gastric distension patients, including those who are symptomatic and using GLP-1 receptor agonists. Approved in December 2024, this quality measure is set to be active for data collection and submission for the payment year of 2025.

NAPA's Quality Team spearheaded this initiative, collaborating with the Anesthesia Business Group (ABG) and Graphium Health to create the Qualified Clinical Data Registry (QCDR) for a better representation of the risks involved in anesthesia.

Addressing the Challenges in Anesthesia Care

NAPA's new measure is part of its effort to combat patient safety challenges, especially concerning patients at a high risk of gastric distension. Physicians are well aware of the delayed gastric emptying effects caused by GLP-1 medications, which can lead to a dangerous buildup of gastric contents, raising the risk of aspiration during surgery despite adherence to fasting guidelines. This situation is compounded by a striking number of cases recently reported, highlighting the crisis that arises when these patients undergo procedural sedation or general anesthesia.

With this new framework, NAPA is innovatively aiming to reduce pulmonary aspiration risks, and it specifically targets interventions for not only patients taking GLP-1 receptor agonists like Mounjaro, Ozempic, and Wegovy, but also other high-risk patients with complications such as bowel obstructions or hernias. This comprehensive approach is a timely and necessary response to an urgent patient safety need.

A Commitment to Patient Safety

Dr. Rafael Cartagena, CEO of NAPA, expressed pride in the organization’s leadership role concerning anesthesia safety. He remarked, "The inclusion of NAPA's quality improvement measure in the CMS Quality Payment Program (QPP) exemplifies our unwavering commitment to patient safety and innovation."

By leveraging collaborations with various stakeholders, including ABG and CMS, NAPA is striving to implement strategies that substantially reduce harm while ensuring clinical excellence in anesthesia care.

This new measure, known as ABG 45 Aspiration Prevention in Patients with Gastric Distension, adds to a suite of six clinical quality measures previously developed through NAPA's proactive initiatives with the ABG QCDR. The significance of these measures cannot be understated, as they enhance clinical practice and bolster the capacity of healthcare professionals to deliver top-quality care to patients across the healthcare system.

Industry and Multi-Society Guidance

Complementing the launch of this measure, a multi-society clinical practice guideline was also released in October 2024. This guidance was a cooperative effort among the American Society of Anesthesiologists (ASA), the American Gastroenterological Association, and other notable entities. It serves to provide clinicians with essential directives concerning the administration of GLP-1 receptor agonists during the perioperative period, specifically emphasizing complications related to gastric emptying.

Conclusion

NAPA continues to solidify its position as a leader in improving perioperative care, not just through guidelines but also through tangible measures that address real-world challenges. As they focus on patient-focused strategies, collaborations with organizations and clinical partners remain key to ensuring that anesthesia practices can adapt and thrive in light of emerging medications and technologies. With the introduction of this new CMS measure, there is hope for a future with fewer complications and substantial improvements in patient outcomes, showcasing the mission-driven dedication of North American Partners in Anesthesia to enhance the standard of care within the anesthesia community.