As value-based care matures, MSSP ACOs face mounting complexity in quality reporting — across EHRs, payers, and evolving CMS requirements. At Healthmonix, we don’t just promise solutions. We’ve already delivered them — at scale, across diverse ACOs, and in direct partnership with forward-thinking healthcare leaders.
Topics: ACO, Quality Performance Category
Quality scores matter!
The Medicare Shared Savings Program (MSSP) saved $1.8 billion for Medicare in 2022, according to last month’s announcement by the Centers for Medicare & Medicaid Services.1 This marks the second-highest yearly savings since the program’s start. It further underscores the program’s track record of consistently generating savings and delivering high-quality performance for the sixth consecutive year, as noted by CMS.
Topics: ACO, MIPS Reporting
The Healthmonix team joined Accountable Care Organization (ACO) leaders throughout the country at the National Association of ACOs (NAACOS) Spring Conference at the beginning of May in Baltimore. There were many great discussions and presentations during the conference, but the hot button topic was eCQM / MIPS CQM reporting. The overwhelming sentiment from the conference is that eCQM reporting is a challenge that all ACOs are struggling with.
The Centers for Medicare & Medicaid Services (CMS) provided strong language to ACOs saying that the timeline for mandatory eCQM / MIPS CQM reporting is not going to change. CMS encouraged ACOs to use the program years of 2023 and 2024 for strategic preparation and building their infrastructure in advance of the mandatory transition in 2025.
Topics: ACO, Accountable Care Organization
The 2023 Physician Fee Schedule (PFS) Final Rule was released in November 2022, finalizing many of the promised features of accountable care organizations (ACO) quality reporting. A couple weeks ago, I wrote about the Quality reporting requirements and Healthmonix's strategies to approach the upcoming changes. For Part 2 of this discussion, I will be introducing the new Health Equity Adjustment and why it will impact quality reporting moving forward.
Part 3 will cover the move from all or nothing scoring to a scaled approach.
Once again, if you are a visual learner, you can get most of this information from our latest webinar.
Topics: MACRA & MIPS, ACO, APM Performance Pathway, 2022 PFS Final Rule, Accountable Care Organization, health equity, Health Equity Adjustment
The 2023 Physician Fee Schedule (PFS) Final Rule was released on November 6, 2023 and included over 3,000 pages of the Centers for Medicare & Medicaid Services (CMS) regulations and rulings for the 2023 year. While there is a ton of information to cover the entire rule, I would like to share what you need to know about the impact on the Medicare Shared Saving Program (MSSP) for Accountable Care Organizations (ACOs). In the first of this three-part series, I will cover Quality Reporting Requirements and Strategy. Subsequent blogs will cover Introduction to the Health Equity Adjustment and The Move from All or Nothing Scoring to a Scaled Approach .
If you are a visual learner, you can get most of this information from our latest webinar.
Topics: ACO, APM Performance Pathway, Medicare Shared Savings Program, Accountable Care Organization, MIPS CQMs, eCQMs, 2015 Edition CEHRT, certified electronic health record technology, 2015, 2023 PFS Final Rule
If you are managing a Medicare Shared Savings Program accountable care organization (MSSP ACO), you have heard the mandate from the Centers for Medicare & Medicaid Services (CMS) to move to eCQM/CQM reporting, replacing the Web Interface reporting. You may also be aware of the significant pushback that ACOs, collectively and independently, have provided to CMS. At this year’s fall National Association of ACOs (NAACOS) conference, the tenor changed to accepting the move, optional in 2022 through 2024, but required in 2025.
Topics: ACO, APM Performance Pathway, Accountable Care Organization, MIPS CQMs, eCQMs
The 2023 Provider Fee Schedule Proposed Rule was released in July and there are changes that accountable care organizations (ACOs) need to be aware of. This blog will focus on the most important changes from a quality reporting perspective.
Topics: ACO, APM Performance Pathway, 2023 Proposed Rule, health equity
The NAACOS Fall 2021 Conference was the first live meeting that the Healthmonix team attended since HIMSS 2020 was cancelled in March of that year. It was certainly reinvigorating to meet in person, discuss the state of payment models, and hear from CMS regarding their vision.
Topics: CMS, ACO, Industry insights, 2021 PFS Proposed Rule
For ACOs participating in the Medicare Shared Savings Program (MSSP), CMS is implementing rules in 2021 and 2022 for quality reporting which include a sweeping change. This change will require a new reporting approach, in order to aggregate data from electronic health record systems used across an ACO for all patients seen by any provider, regardless of payer or participation in the ACO. In a recent survey, nearly 75% of the ACO respondents indicated concern with the challenge of these requirements. The Web Interface reporting is being sunset, and ACOs need to devote attention to determining their strategy for transitioning quality reporting. Success will require thoughtful planning and experienced system implementation.
Topics: ACO, APM Performance Pathway, Medicare Shared Savings Program
Between 2018 and 2019, 74 of Medicare’s 561 accountable care organizations (ACOs)—or 13%—left the program, according to research by Leavitt Partners. The same research also found that 26% of ACOs that reached the end of their three-year agreement opted to not renew it at the end of 2018.
