Navigating the Future of Healthcare Quality Reporting: ACOs Take Center Stage

The landscape of healthcare quality reporting is evolving, and Accountable Care Organizations (ACOs) are spearheading this transformative journey. In 2025, a pivotal shift awaits as ACOs transition from traditional CMS Web Interface reporting to Electronic Clinical Quality Measures (eCQMs), aligning seamlessly with the Quality Payment Program (QPP) Merit-Based Incentive Payment System (MIPS).

Enlightened Embracing Change for Enhanced Patient Care

While eCQM reporting remains optional until 2025, forward-thinking ACOs have already embraced this change. An ACO in the Southeast, for instance, reaped financial benefits and process improvements by early adoption, thanks to concessions from CMS. This article sheds light on four best practices to aid organizations in optimizing their internal teams, updating information systems, and analyzing quality data for effective eCQM reporting.

1. Addressing the Challenge of Multiple EHRs

2025 introduces a reduction in the number of measures to three, applicable to the entire patient population. However, reporting via API poses technical challenges, requiring each ACO to find a solution if without an API-enabled submission partner. The central challenge lies in aggregating, normalizing, and addressing care gaps across diverse EHRs.

2. Best Practices for Effective Preparation

To ensure optimal eCQM reporting, the article outlines five strategies derived from hands-on experience with ACO customers:

• Implement a Best Practice Data Process: Establishing a workflow for aggregating and analyzing data is fundamental for identifying and addressing gaps strategically.
• Manage Data Complexity: Prioritize data integrity and timeliness, leveraging external organizations like the National Committee for Quality Assurance (NCQA) for data validation.
• Identify and Close Gaps: Proactively collect necessary data for quality scoring, understanding current performance, and addressing existing data gaps.
• Collaborate and Educate: Foster effective collaboration with practices and focus on educating providers' teams, particularly primary care providers, for accurate documentation.
• Reduce Redundancy: Streamline quality information capture by identifying providers best suited for measure screening and interventions.

Enlightened Preparing for Tomorrow's Healthcare Landscape

As ACOs brace for the mandatory shift to eCQM reporting in 2025, strategic preparation, collaboration, and a commitment to data integrity will be paramount. This article aims to guide ACOs on a path of seamless adaptation, ensuring the continued delivery of high-quality patient care.