Healthmonix Media Coverage

Shared Savings ACOs get two years to brace for heavy APP, eCQM lift

Posted by Healthmonix on Nov 15, 2021 4:38:00 PM

by Roy Edroso

CMS finalized the delay of controversial reporting changes for Shared Savings accountable care organizations (ACO), but stakeholders remain concerned that those changes will make the program significantly more difficult in the future.




The mandatory reporting of electronic clinical quality measures (eCQM) under the new Alternative Payment Model (APM) Performance Pathway (APP) that was slated to begin in 2022 under previous rulemaking is delayed until 2025, according to the final 2022 Medicare physician fee schedule released Nov. 2 (PBN 7/26/21). eCQMs are extracted from the participant’s EHR systems and include data not previously included in
Medicare reporting, such as data from private insurers.

Participants who feel ready can get started now. But know the rules: Whenever you choose start, you will have to report three eCQMs or MIPS CQM measures; abandon the
popular CMS Web Interface reporting method; and perform the CAHPS for MIPS survey. You will also have CMS report two administrative claims data measures on your behalf.
For those who wish to wait, you will report regular measures until 2025. The program performance threshold will be held at the 30th percentile through 2023. In
2024, it escalates to the 40th percentile. 

Coming of eCQMs Lauren Patrick, president and CEO of qualified registry Healthmonix in Malvern, Pa., says registries have been working with CMS for years on the development
of eCQM reporting. “While we agree it is a large task to combine this data effectively across an ACO, and many EHRs present challenges in interoperability,” Patrick thinks it’s both necessary and doable. “If an ACO cannot combine data about a patient’s A1c,” she
asks, “how are they managing that care?”

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Topics: ACOs, APM Performance Pathway, ACO Reach