as of怎么理解？

The CAHPS survey counts as one patient experience measure and also meets the requirement to report a high priority measure. Of broader relevance to the issue of payment for treatments to relieve pain of spinal origin, in 2017 CMS announced that as of January 2018, all institutions’ responses to the three HCAHPS questions related to in-hospital pain control were to be delinked from quality-based payment adjustments.The basis for this change lays in a suspicion (admittedly without supporting evidence, according to CMS) that asking inpatients to rate their pain intensity might ultimately result in greater quantities of prescription opioid analgesics being available with consequences such as substance abuse and overdoses. Regardless of the impact of this change for payment, it illustrates how pain treatment and payment for it have been affected by the recent epidemic of substance use disorder, particularly opioid abuse including overdoses.

患者体验指标：CAHPS评估作为一项患者体验指标，也满足上报高优先级指标的要求。与脊柱源性疼痛治疗的支付问题更为相关的是，2017年CMS宣布：在2018年1月之后，所有机构对与院内疼痛控制相关的3个CAHPS问题的回应都将会与基于质量的支付调整脱钩。这个改变是基于CMS的一种假设（无证据支持），即要求住院患者评估其疼痛强度可能最终导致处方阿片类镇痛药用量增加，从而引起药物滥用和药物过量等后果。不管这种支付变化最终会有什么影响，它说明了近期药物（特别是阿片类药物）的滥用是如何影响疼痛治疗和支付的。

as of怎么理解？我理解为“之后”

但是网络上查到这样的说法：

引用:在什么时候,到...时止,是比较书面的表达方法。

I know that as of last week he was still unmarried.

我知道到上星期为止他还没有结婚

不知道as of怎么理解？