EHR submissions for all eCQMs and registry submissions for MIPS CQMs are the only two quality options open for ACO reporting in 2022.
QPP MIPS has already informed MSSP ACOs about the alarming signs for ACO reporting in 2022. For a successful transition from MIPS to MVPs, PY 2022 and 2023 are significant years for QPP. Thus, CMS has provided Medicare ACO with regulations for ACO reporting in PY 2022. Moving back to PY 2021, CMS has considered CAHPS for ACOs Survey measure as a separate measure. However, CMS has finalized a new initiative from the PY 2022 ACO reporting. Thus, ACOs have to report the APP measure set with two allowed reporting options only. The two reporting options for ACO performance quality data submission are given as follows:
EHR-based quality submissions
Qualified Registry-based Submissions
Let’s find out new ways coming our way with ACO quality reporting options in 2022!
APP Measure Set Framework for PY 2022
Meanwhile, CMS has modified the specification for the APP measure set as well. Now, each APP measure set will have a constitutional framework of the following:
Three Clinical Quality measures
The CAHPS for MIPS Survey measures (as one measure)
Two Administrative Claims measures
Comparing APP Measure Set Construct with the PY 2021 Set
- There was CAHPS for ACO Survey measures in place of CAHPS for MIPS Survey measures in the 2021 measure set.
- Since CMS has secure readmission measures for MIPS, therefore readmission measures for accessing ACOs are different. The readmission measures are concerned with activities under a period of 30 days when a patient discharges from the hospital.
- Sometimes, the patients receive their medical services at home due to their chronic conditions. Thus, CMS is working on new ‘Days at home’ measures for ACO reporting in the coming years.
- Moreover, CMS has issued the ‘All-patients reporting’ criteria for quality reporting. Customarily, the ACOs had to report only a selected group of patients. However, CMS now requires reporting at least 70 percent of patients that fulfills the measure criteria. This significant change seems a unique approach in ACO reporting 2022.
There is a little confusion about all-patient reporting among ACOs. What if these patients have different payers? In other words, the patients might come with an insurance plan from different insurance companies. So if such patients fall under the measure criteria, then what should ACO do?
Well, CMS has forwarded one simple solution for this specific case. ACOs can still report such patients regardless of their payer types. CMS has nothing to do with the payer type. All CMS has concerns with the delivery of high-quality care episodes to every patient. And ACO reporting is another way of analyzing the finest healthcare performance of providers.
Reporting Options Available for ACO Reporting 2022
We have depicted earlier in our discussion that CMS Web Interface will no longer be available for ACO reporting. Not only for ACOs, but CMS has also expired Web interface for MIPS, APPs, and MVPs as well. Consequently, all ACO Medicare have left with two options; eCQM (EHR submission) and MIPS CQM (registry submission).Similarly, ACOs have a direct login option for data submission via Application Program Interface. And if they do not have their API profile yet, they must sign in first and then, upload their data. Here, ACOs can trust any ACO-qualified registry that acts as a third-party intermediary in ACO reporting. The ACO QRs are aware of the API platform, they deal with submission data programmatically with their CEHRT.
Instructions for EHR Submissions
According to CMS, eCQMs are;A clinical quality measure that evaluates the standard of healthcare. It gathers organized patient data while the patient is receiving care. Moreover, it articulates and sets up systems to utilize data from EHRs and/or other health IT.
Last but not least, according to the CMS QPP website, if an ACO switches systems during the performance year, data should be combined from the old and new EHRs into a single report for the whole 12-month period before the data are submitted. If a full year's worth of data is not accessible (for instance, if aggregation is not feasible), data completeness must account for the whole year. Both of your EHR systems must be 2015 Edition CEHRT if you are submitting eCQMs.
