As ACOs begin to make changes around implementing a solution to meet the new reporting requirements, make sure your team is up-to-date on all eCQMs!
For many health organizations, requirements around reporting electronic clinical quality measures (eCQMs) add complexity when capturing data, especially if they use multiple software. Ensure your organization has a seamless knowledge on reporting and capturing metrics to enhance overall business-producing activities during implementation.
What are eCQMs?
eCQMs are electronic and automated measures of the clinical quality provided to patients in a specified standard format using data extracted from the electronic health record (EHR). The accuracy of this reporting is based solely on the appropriate documentation of data in the EHR.
Since 2016, it has been required by law for hospitals to report on eCQMs data, however, those requirements are changing. The Centers for Medicare & Medicaid Services (CMS) makes eCQMs available to eligible hospitals, clinicians, and critical access hospitals to measure, track and report the quality of healthcare services across several specific areas of operation, including:
- Clinical processes/effectiveness
- Patient safety
- Care coordination
- Efficient use of healthcare resources
- Patient and family engagement
- Population health
When completed correctly, with one submission, filing and administrative burdens are reduced. Here are some of the most common questions around eCQMs answered.
1. What are the benefits of eCQMs reporting?
There are several benefits of using eCQMs in your healthcare facility.
- eCQMs use clinical data to assess the outcomes of treatment by measured entities.
- eCQMs reduce the burden of manual abstraction and reporting for measured entities.
- eCQMs foster the goal of access to real-time data for point-of-care quality improvement and clinical decision support.
2. How must Accountable Care Organizations (ACOs) report?
ACOs are in a transition period where they can use the web portal or Alternative Payment Model Performance pathway to report. In 2025 the web interface method will end for all ACOs, and the new reporting requirements will be instated.
3. What is the impact of reporting on reimbursement?
Currently, CMS has incentives to encourage the adoption of eCQM into ACOs. If ACOs implement reports by both the web portal and eCQM, the higher scores will be measured.
4. What is the operating cost of eCQM?
eCQM will need the overhead of many organizational departments, like technical, workforce, financial, and legal resources. If an organization chooses to incorporate the reporting without an integrated software tool, clinical workflows and administrative processes will need a redesign. An all-in-one EHR tool with eCQM capabilities makes it simple to focus on patient care than worrying about analytical data.
5. What challenges will come with the reporting change?
Formerly, ACOs only reported on a sample of Medicare patients for whom they provided direct care. Reports show, in 2021, only 12 out of 500 ACOs were reported by eCQM. By 2025, ACOs will be required to analyze 100% of patients and report on 75% of all patients who meet the measuring criteria, regardless of payer. The challenge will be implementing this new structure in an ecosystem already strained by fragmented data across multiple areas.
The main challenge will stem from ACOs collecting patient data across multiple EHRs serviced by multiple vendors under multiple contracts. The National Association of ACOs reported that more than 75% of ACOs have six or more EHRs, and close to 40% use more than 15 EHRs across multiple settings.
With the new required reporting, ACOs will submit a single aggregate quality reporting document from these multiple data systems. Due to most EHRs being used for patient charting and reimbursement purposes, the lack of proper formatting capabilities will present challenges. It may be a big struggle to complete conversions with the new reporting requirements unless the organizations implement an up-to-date solution that simplifies reporting (and, sidenote, the sooner this is implemented, the better!).
6. What is the patient matching challenge?
Having multiple EHRs also presents the challenge of patient matching. To ensure data quality and proper reporting standards for accurate patient matching that provides an accurate, holistic view of the patient, ACOs will need to be able to deduplicate patient data across reports.
The Solution to Advanced Reporting
You deserve a software partner, not a vendor, as your organization moves towards implementing eCQMs. Clinigence Health eliminates the challenges ACOs will encounter with implementing tools for the new reporting requirements. Our organization has:
- 10+ years of experience reporting eCQMs and CQMs for multiple EMR healthcare entities
- The ability to support not just eCQMs but also CQMs (which is a requirement if you cannot report electronically on 100% of your patient population)
- Early availability of eCQM and CQM updates relative to EHRs
If you are an ACO looking to integrate a solution for eCQMs reporting, you should consider the strategic advantages of Clinigence Health. Our eCQMs offer ACOs a tool to architect a data infrastructure that effectively solves the interoperability challenge and transforms the organization’s data aggregating and analytics capabilities to enhance patient care.
Clinigence Health helps ACOs simply optimize their value-based care contracts and enhance other capabilities like population health management, risk stratification, decision support at the point-of-care, continuous care across multiple settings/providers, and robust data analytics.
Contact a member of our expert team today to discuss how our solution can help meet your business needs!