A New ERA in CMS Quality Data Submissions – 2021

ACO’s that have been relying on the comfort of submitting CMS Web Interface reports during the 2021 buffer year will no longer have that luxury come 2022 as CMS completely switches to the eCQM or MIPS CQM reporting model. This means that organizations must implement a technology that allows them to switch to an electronic method of reporting as well as one that allows them to report on all-patient data regardless of payer. Implementing these new objectives across multiple EHRs is sure to frustrate many. Those that are able to successfully carry it out in the next few months will reap the rewards while avoiding costly penalties.
Manual submissions meet electronic reporting

As we mentioned earlier, ACO’s have historically submitted quality measures via a CMS Web Interface portal. The quality measures submitted rely on Medicare beneficiary data. Under the new rules, however, ACOs must use an EHR to capture electronic CQMs (Clinical Quality Measures) or work with a registry that supports MIPS CQMs.

Put in another way, at the moment eCQMs can be calculated via chart abstraction and submitted manually via attestation in ePIP. Under the new APP (APM Performance Pathway), however, these submissions must be done via a single CEHRT (Certified EHR Technology) or multiple EHRs.

New for 2022: All-payer data will go live

One of the most critical changes coming to submissions in 2022 will be the requirement to report on data from all patients, regardless of payer. CMS will then use this “all-payer” data to evaluate ACO performance. ACOs will have to submit three measures to CMS:

  1. Diabetes: hemoglobin A1c Poor Control
  2. Preventive Care and Screening: Screening for Depression and Follow-up Plan
  3. Controlling high blood pressure

Now, ACOs will need to report these measures for all patients and not just Medicare beneficiaries. If they fail to boost performance on all patients instead of just beneficiaries, ACOs run the risk of underperforming. This can affect whether or not the provider group receives benefits or financial penalties. Reporting on all-payer quality data will pose a major challenge for ACOs in the next few months. How they go about shifting their reporting programs will play a huge factor on their success.

Flexible data capture is critical

Implementing new reporting standards from CMS will be challenging for ACOs. When you factor in those that are running multiple EHRs at the same time, things will be much trickier. Due to the 12-month long implementation plans of new EHRs, data capture will need to be more flexible and aligned with how care providers work on a daily basis. This means expanding beyond the vendor’s configuration of EHR as the single source of data capture within the organization.

Advanced Care Management

Advanced care management from one single platform takes care of every step in the administrative process from care coordination to revenue enhancement. This lowers provider burden and allows for a greater range of stakeholder innovation like combining EHRs.

Persivia CareSpace® offers a quick solution

By turning towards Persivia’s Population Health Management platform CareSpace®, ACOs will have access to data extraction capabilities for all patients and not just Medicare patients. Additionally, CareSpace® can tailor reliable data extracts across multiple EHRs before standardizing and transforming them to help take some of the burden off of providers when submitting to CMS. More specifically, Persivia’s internal population health management infrastructure can support:

• Data management
• Interoperability
Care Management
Care Coordination
Cost and Utilization Analytics
Quality Reporting
• Patient Engagement
• Revenue Enhancement
VBC Solutions including BPCIA, ACO, CPC+

CareSpace® can seamlessly integrate into existing operational workflows with minimal disruption and can be implemented without breaking the bank.
As we noted before, adding new EHRs can lead to significant performance pathway changes. Persivia’s AI-driven workflow automation tools can help scale the ACOs processes and reduce administrative workloads by 90%. These tools also have clinical support functionalities that can improve quality as well as identify potential gaps in care so they can be closed in real time. This can be the difference maker when it comes to not only complying with the new CMS requirements but also thriving in this new era.

Don’t be left behind – less than four months remain until the new eCQM submission rules go into effect. Schedule a demo with us today to learn how we can help you move towards a successful transition.