APM Performance Pathway

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the 2025 Medicare Physician Fee Schedule (PFS). The final rule includes several key changes affecting Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs), as CMS continues its shift towards digital quality measures (dQMs). With the CMS Web Interface ending after the 2024 performance year, the final rule focuses on the future of quality reporting by aligning with the Universal Foundation of quality measures and extending eCQM / MIPS CQM reporting incentives. This blog summarizes the changes and their implications for ACOs in 2025 and beyond.

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2025 Medicare Physician Fee Schedule (PFS). The proposed rule includes several key changes affecting Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs), as CMS continues its shift towards digital quality measures (dQMs). With the CMS Web Interface concluding after the 2024 performance year, the proposed rule focuses on the future of quality reporting by aligning with the Universal Foundation of quality measures and extending electronic Clinical Quality Measure (eCQM) reporting incentives. This blog summarizes the proposed changes and examines their implications for ACOs in 2025 and beyond.

Accountable Care Organizations participating in the APM Performance Pathway (APP) must meet annual quality data reporting requirements. Quality data must be submitted to the Centers for Medicare and Medicaid Services (CMS) in a specified format which may be a challenge for some Accountable Care Organizations (ACOs). If your electronic health record (EHR) system is unable to aggregate all eligible patients and de-duplicate them at your ACO Entity ID level or if you need to aggregate data across more than one EHR, MDinteractive can help by converting your quality data into the acceptable format for submission to CMS. 

Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program will have new reporting requirements beginning in 2025. The Centers for Medicare and Medicaid Services (CMS) has established a multi-year transition period to change the data that these organizations must report and how the data gets submitted. The changes are intended to reduce reporting burdens and improve patient outcomes. Partnering with a CMS Qualified Registry like MDinteractive can ease the transition for ACOs and help them meet their data reporting needs. 

The Centers for Medicare and Medicaid Services (CMS) will delay the requirement that Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) begin reporting all-payer Quality data through the new APM Performance Pathway (APP). ACOs will have the option to continue submitting data via the CMS Web Interface through the 2024 performance year. ACOs will have to report all three APP Quality measures (CQMs or eCQMs) beginning in 2025. In this article, we highlight the implications for ACOs, including the new APP quality measure set and strategies for successful reporting in future years.