What you need to know now:
- Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) are required to report the Alternative Payment Model (APM) Performance Pathway (APP) Plus quality measure set via the APP to meet the quality performance standard used to determine shared savings and shared losses.
- In 2025, ACOs can report quality data through the APP and can choose to actively report 4 eCQMs, MIPS CQMs, or Medicare CQMs. The CMS Web Interface will not be available in 2025.
- In addition, ACOs must field the CAHPS for MIPS Survey, and CMS will calculate 1 measure using administrative claims data.
- The 4 eCQMs / MIPS CQMs / Medicare CQMS include:
- ACOs will be able to choose a submission method to report the 4 quality measures that best meet their specific needs (e.g., direct, login and upload, or a third-party intermediary). This means ACOs could choose a CMS Qualified Registry like MDinteractive to report quality data to CMS on their behalf.
- ACOs will receive a score of between 1 to 10 points for each measure that meets data completeness (submitted data for at least 75% of the denominator eligible patients/instances) and case minimum (at least 20 cases) requirements, which would be determined by comparing measure performance to established benchmarks.
- Further guidance can be found on these CMS documents:
- Reporting MIPS CQMs and eCQMs in the Alternative Payment Model Performance Pathway (APP)
- 2025 APM Performance Pathway Toolkit Fact Sheet
- 2025 APM Performance Pathway Toolkit_Infographic
- 2025 APM Performance Pathway Toolkit_Quick Start Guide
- 2025 APM Performance Pathway Toolkit_Scoring Guide
- 2024 Data Aggregation Resource
- Reporting MIPS CQMs and eCQMs in the APM Performance Pathway (CMS webinar)
- Medicare Shared Savings Program Quality Performance Standard: Performance Year 2025 40th Percentile MIPS Quality Performance Category Score
- The quality performance standard is the minimum quality performance ACOs must achieve to be eligible to share in savings at the maximum rate available for the ACO’s track. For PY 2025, ACOs that report the APP Plus quality measure set can meet the quality performance standard via one of three pathways:
- For all ACOs: Achieve a health equity adjusted quality performance score that is equivalent to or higher than the 40th percentile across all MIPS Quality performance category scores, excluding entities/providers eligible for facility-based scoring.
- For ACOs that report the 4 eCQMs/MIPS CQMs and meet the MIPS data completeness requirement for all 4 measures: Achieve a quality performance score equivalent to or higher than the 10th percentile of the performance benchmark on at least 1 of the 3 outcome measures in the APP Plus quality measure set and a quality performance score equivalent to or higher than the 40th percentile of the performance benchmark on at least 1 of the 5 remaining measures in the APP Plus quality measureset.
- For ACOs in their first performance year of their first agreement period: Meet the MIPS data completeness requirement on the 4 eCQMs/MIPS CQMs/Medicare CQMs in the APP Plus quality measure set, receive a MIPS Quality performance category score, and administer the CAHPS for MIPS Survey.
How MDinteractive can help:
- Assistance with compliance: MDinteractive can help ACOs comply with the data reporting requirements while supporting your ability to make informed decisions on how best to improve the quality of care for Medicare patients within your organization.
- One-stop reporting for required Quality eCQMs and CQMs: Measures #1, #112, #134, and #236 can be reported via MDinteractive.
- Flexible data input: MDinteractive can accept various types of quality data files and also provides software “tools” that can be used to build quality reports.
- Flexible submission choices: MDinteractive can accommodate data at the ACO level, by participating TIN, or at the individual clinician level.
- Monitoring performance: MDinteractive software allows you to plan, track and optimize your quality data reporting and performance through an interactive dashboard. You will have the ability to monitor your performance at the ACO, TIN, and clinician level throughout the year and make necessary quality improvements within your organization to maximize your incentive payments.
- Responsiveness to changes within your organization: MDinteractive has extensive experience aggregating quality data from multiple EHRs before submission to CMS.
- Hands-on customer support at all stages in the reporting process: At MDinteractive, our seasoned team will help you navigate through the reporting process from beginning to end and offer advice on how to maximize your reimbursement and avoid sharing losses.
If you are participating in the program, contact us today to discuss how we can help you meet the annual Quality reporting requirements. We offer flexible data collection options to make tracking and reporting these measures a simple process for you and your practice.
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