ACO / APM Performance Pathway (APP) Registry

What you need to know now:

• In 2025, ACOs can report quality data through the APM Performance Pathway (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: 
  • #1 Diabetes: Glycemic Status Assessment Greater Than 9%
  • #112 Breast Cancer Screening
  • #134 Preventive Care and Screening: Screening for Depression and Follow-up Plan
  • #236 Controlling High Blood Pressure
• 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)
  • 2024 APM Performance Pathway Fact Sheet
  • 2024 APM Performance Pathway Quick Start Guide
  • 2024 APM Performance Pathway 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: 40th Percentile MIPS Quality Performance Category Score for Performance Year 2024
  • Medicare Shared Savings Program Quality Performance Standard: Performance Year 2025 40th Percentile MIPS Quality Performance Category Score
• CMS will gradually increase the level of quality performance required for all ACOs to meet the Shared Savings Program quality performance standard and has included an incentive to report the 3 eCQMs/CQMs in the 2024 performance year: 
  • 2024 - ACOs will meet the quality performance standard used to determine shared savings and losses if the ACO:
    • Achieves a quality performance score equal to or higher than the 40th percentile across all MIPS quality performance category scores. For 2024, the quality performance standard is based on MIPS quality performance category scores from PY 2020 through PY 2022 and equals 77.05 points. This CMS resource provides more information; or 
    • Reports the 3 eCQM/MIPS CQM measures and achieves a quality performance score equal to or higher than the 10th percentile of the performance benchmark on at least 1 outcome measure and achieves a quality performance score equal to or higher than the 40th percentile of the performance benchmark on at least 1 other measure. 
  • 2025 and subsequent performance years - An ACO will meet the quality performance standard used to determine shared savings and losses if the ACO achieves a quality performance score equal to or higher than the 40th percentile across all MIPS quality performance category scores.

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 organizations.
• One-stop reporting for required Quality CQM’s: 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.

Check out this blog for more information.

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