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MIPS Blog

Changes Ahead for ACO Reporting

Posted on November 30, 2020
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Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program will have new reporting requirements beginning in 2021.  In its Final Regulation for the Quality Payment Program (QPP), the Centers for Medicare and Medicaid Services (CMS) is changing the data that these organizations must report each year and how the data gets submitted. The changes are intended to reduce reporting burdens and improve patient outcomes. ACOs will be able to partner with CMS Qualified Registries like MDinteractive to meet their data reporting needs.

Elimination of the CMS Web Interface in 2022

CMS will end the CMS Web Interface data submission method for ACOs, registered groups and APM Entities beginning with the 2022 performance period.  There will be a one-year transition period in 2021.  During the transition year ACOs will have the option either to continue to report via the CMS Web Interface or to report on the 3 eCQM/CQM MIPS measures established under the new Alternative Payment Model (APM) Performance Pathway before being required to report on the 3 eCQM/MIPS CQM measures beginning in 2022. 

The APP is available only to participants in MIPS APMs (which includes ACOs) and can be reported by the individual eligible clinician, group, or APM Entity. ACOs will be required to report their data via the APP beginning in 2021.  This new pathway is designed to align with the MIPS Value Pathway (MVP) framework when it is implemented. 

CMS has adopted the following schedule to implement the new reporting requirements for ACOs:

  • For the 2021 performance year, ACOs will be able to choose to actively report either the 10 measures under the CMS Web Interface or the 3 eCQM/MIPS CQM measures designated under the APP Measure set via a CMS Qualified Registry like MDinteractive or EHR.  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.
  • Beginning in 2022 and beyond, ACOs will no longer be able to report via the CMS Web Interface.  ACOs will be required to actively report quality data on the 3 eCQM/MIPS CQM measures via the APP using a registry or EHR. 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. 

APP Quality Measure Set

CMS is adopting a smaller measure set as part of the APP as highlighted in the table below.

*2021 Only:  ACOs will have the option to report via the CMS Web Interface. 

Measure #Measure TitleCollection TypeSubmitter Type
Quality ID#: 321CAHPS for MIPSCAHPS for MIPS SurveyThird-Party Intermediary 
Quality ID#: 479 Hospital-Wide, 30-day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician GroupsAdministrative ClaimsN/A
Quality ID#: 480Risk Standardized, AllCause Unplanned Admissions for Multiple Chronic Conditions for ACOsAdministrative ClaimsN/A
Quality ID#: 001Diabetes: Hemoglobin A1c (HbA1c) Poor ControleCQM/MIPS CQM/CMS Web Interface* APM Entity/ThirdParty Intermediaryy 
Quality ID#: 134Preventive Care and Screening: Screening for Depression and Follow-up PlaneCQM/MIPS CQM/CMS Web Interface* APM Entity/ThirdParty Intermediary
Quality ID#: 236 Controlling High Blood PressureeCQM/MIPS CQM/CMS Web Interface* APM Entity/ThirdParty Intermediary 
Quality ID#: 318Falls: Screening for Future Fall Risk CMS Web Interface*APM Entity/ThirdParty Intermediary
Quality ID#: 110Preventive Care and Screening: Influenza Immunization CMS Web Interface*APM Entity/ThirdParty Intermediary
Quality ID#: 226Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface*APM Entity/ThirdParty Intermediary 
Quality ID#: 113Colorectal Cancer Screening CMS Web Interface*APM Entity/ThirdParty Intermediary 
Quality ID#: 112Breast Cancer ScreeningCMS Web Interface*APM Entity/ThirdParty Intermediary 
Quality ID#: 438Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface*APM Entity/ThirdParty Intermediary
Quality ID#: 370Depression Remission at Twelve MonthsCMS Web Interface*APM Entity/ThirdParty Intermediary 

ACOs must also meet a new quality performance standard in order to qualify to share in savings or avoid owing maximum shared losses.  CMS will gradually phase-in the increase in the level of quality performance as follows:

  • Performance years 2021 and 2022 - the ACO must achieve a quality performance score that is equivalent to or higher than the 30th percentile across all MIPS Quality performance category scores; and    
  • Performance year 2023 and subsequent years - the ACO must achieve a quality performance score that is equivalent to or higher than the 40th percentile across all MIPS Quality performance category scores.  
     

Benefits of Using a Registry

While ACOs can choose to continue using the CMS Web Interface in 2021, they will not have this option in 2022 and future years.  Collaborating with a registry will make sense for many ACOs. Registries like MDinteractive can help ACOs comply with the data reporting requirements, while supporting their ability to make informed decisions on how best to improve quality of care for Medicare patients within their organizations.

Combining Data from Multiple Sources.

We understand your organization may face data collection and reporting challenges if you are switching to a new Electronic Health Record (EHR) system mid-year or are currently using multiple EHR platforms. We have extensive experience aggregating quality data from multiple EHRs before it gets submitted to CMS.

Know Your Performance.

Our software allows you to plan, track and optimize your quality data reporting and performance. 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.

Reliable Data Reporting.

MDinteractive has over 20 years of quality reporting experience with healthcare clinicians of all sizes and in all practice settings in every state. Our customers include large academic medical centers, hospitals, billing companies, multi-specialty clinician groups, small groups and solo practitioners.

Knowledgeable and Experienced Team.

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.

Key Takeaways

ACOs should begin evaluating their quality reporting strategy in light of the changes to the quality metrics they must report and the elimination of the CMS Web Interface in 2022.  Partnering with an experienced registry like MDinteractive can help make it a smooth transition. We can help ACOs successfully comply with their quality reporting requirements and provide tools and support to help them increase their Medicare payments through higher earned shared savings.

MACRA MIPS ACO Reporting APM Performance Pathway CMS Web Interface

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