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Healthcare Agencies Ask HHS to Delay Quality Measurement Rep...
Health Policy, News

Healthcare Agencies Ask HHS to Delay Quality Measurement Report for ACOs

Eleven healthcare agencies have called on the Biden administration to delay the early implementation of quality measurement reports for ACOs (accountable care organizations) due to unanswered questions and potentially negative consequences for patient care.

They called for changes in mandatory quality measurement reporting for accountability service providers.

Healthcare organizations, including the American Hospitals Association and the American Medical Association, have sent a letter to the Department of HHS Secretary Javier Becerra for delays or other options.

The ACO Coalition has sent a separate letter to Becerra expressing concern.

The concern relates to changes in the quality report for the Medicare Shared Savings Program published in the Final 2021 Medicare Physician Phase Schedule Rules.

Why Are There Issues?

The issue is the collection of ACO hospitals and physician practices do not necessarily use the same electronic health care system.

The ACOs of the Medicare Shared Savings Program are being asked to collect separate data from electronic health record systems, which is not interrelated.

The reporting requirements in the final rules do not relate to the Office of the National Coordinator. The work of the ONC to create standards for interoperability does not extend to the integration and reporting of quality measurements.

These changes are expected to take effect this year and later, with the most significant orders in 2022.

The most practical picture in creating a system for collecting and collecting data from different EHRs is to invest in data vendor solutions. It is an investment that, in response to a report by the National Association of ACOs, said 373% of ACOs would spend $ 9499,000.

Also, ACO needs to report data on all types of patient criteria, regardless of the prescriber, collect data from non-ACO providers. They need to raise issues for patients who have no connection to the ACO.

“The changes ignore the time it takes to take and implement electronic measures,” the letter said. “Therefore, changes in core policy and extra time are needed to ensure that ACOs can participate successfully and patient care is not adversely affected.”

The letter made several recommendations based on input from ACOs. These are:

  • Delaying mandatory reporting for at least three years;
  • Restricting ACO reports to ACO-granted beneficiaries only, rather than to all patients of the provider alone;
  • Alternative Payment Model Performance Pathway Measurement Set Requires additional input prior to taking appropriate measures for the proper restoration of measures and MSP reporting;
  • Clarify and establish advance quality performance criteria for all ACO reporting options;
  • Payments for reporting are retained when remedies are newly introduced or revised.

The Big Trend

Medicare and Medicaid Services Centers finalize the 2021 Medicare Physician Fee Schedule and Rules Electronic Quality Measures in December 2020.

The rule requires the adoption of an electronic clinical quality system in 2022 or a clinical quality system for merit-based incentive payment systems.

On Record

Cliff Gauss, president and chief executive of the National Association of ACOs, said: “In the midst of a global pandemic, CMS needs these changes, which have alarming clinical benefits and it seems imperative to spend thousands of dollars on ACOs and allow easy compilation of these data.”


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