ACO / APM Performance Pathway (APP) Registry

What you need to know now:

  • Beginning with the 2021 reporting year, ACOs can report quality data via the new APM Performance Pathway (APP) and can choose to actively report either the 10 measures under the CMS Web Interface or 3 MIPS eCQMs/CQMs. ACOs will be required to report via the APP beginning in 2025.
  • In addition, ACOs must field the CAHPS for MIPS Survey, and CMS will calculate 2 measures using administrative claims data.
  • Based on the ACO’s chosen reporting option, either 6 or 10 measures will be included in the calculation of the ACO’s MIPS quality performance category score.
  • If an ACO chooses to report both the 10 CMS Web Interface measures and the 3 eCQMs/CQMs, it will receive the higher of the 2 quality scores for purposes of the MIPS quality performance category.
  •  The 3 eCQM/CQMs include: 
  • ACOs will be able to choose a submission method to report the 3 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 3 to 10 points for each measure that meets data completeness (submitted data for at least 70% 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.
  • The CMS Web Interface will sunset after the 2024 performance year and ACOs must report the 3 eCQMs/MIPS CQMs via a CMS Qualified Registry or EHR. For the 2025 performance year and subsequent performance years, ACOs will be required to actively report quality data on the 3 eCQM/MIPS CQM measures via the APP. In addition, ACOs will be required to field the CAHPS for MIPS Survey, and CMS will calculate 2 measures using administrative claims data. All 6 measures will be included in the calculation of the ACO’s 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 2022 and 2023 performance years.
    • 2022 to 2023 - 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 30th percentile across all MIPS quality performance category scores; 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 30th percentile of the performance benchmark on at least 1 other measure. 
    • 2024 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, #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.
  • All-inclusive pricing:  $199 per clinician per year


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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