Based on your responses to the questions in the ACO Data Survey, it's likely that eCQMs are your
organization's best option for the APM Performance Pathway (APP) transition.
What is an eCQM?
eCQM stands for “Electronic Clinical Quality Measure,” and the specifications for eCQMs are exclusively electronic.
eCQM specifications are published in coding language to be automatically inserted into any quality management software. Although in many cases, these specifications are read by developers and interpreted before creating a custom insertion into their software.
Besides an electronic pathway, there is no other way to collect the data required to calculate an eCQM. eCQM submissions must be produced with end-to-end certified software.
“End-to-end” means that once the data is collected from a patient, it’s documented in an EHR, then calculated and aggregated through an automated process. There can be no manual chart abstraction or correction of data or scores in the process.
eCQM submissions can be uploaded to CMS by the practice, by the eCQM vendor, or by a qualified registry.
Certification standards of entities involved in the extraction and calculation of eCQMs are set by the Office of the National Coordinator of Health IT.
Typically, eCQM submissions require strict compliance with a specific documentation workflow, and deviation from the specific workflow often diminishes performance.
Our friendly team is standing by to introduce you to our solutions and answer your questions.
Based on your responses to the ACO Data Survey, you’ll likely be able to transition to all-payer, all-patient reporting using eCQMs to satisfy APP requirements.
There are a handful of circumstances that make eCQMs a better fit for ACOs over MIPS CQMs. Some of those circumstances could be:
Your ACO’s patient population is not too large for eCQM data aggregation an analysis
Your ACO’s member practices are on the same instance of the same EHR system
Your ACO already has a centralized data hub in place, with ONC-certified endpoints at every step along the data journey
Your ACO has dedicated support staff to aggregate, normalize, monitor, and troubleshoot your data
In our experience, it is rare to find an ACO with every detail in place to satisfy APP requirements via eCQMs. With your responses to the survey, you may be on the right track with eCQMs. You’ll find an outline with the specifics you should be aware of before finalizing your selection.
When are eCQMs a great choice?
With careful attention to your specifics, eCQMs can be a great choice. Check the list below for items to consider when evaluating eCQMs for your organization.
Consider your member practice’s EHR status:
You have to have an EHR to use eCQMs.
Your EHR has to be current with ONC certification.
Your EHR may not offer the measures you need for the APM Performance Pathway (APP) – EHRs are not required to certify and offer all eCQM measures.
It may not be affordable, and the price could vary. Some EHR vendors include eCQM service with their license or subscription fees. For others, it is an add-on service for which they charge extra.
Consider your organization’s EHR status:
If your organization uses a single instance of the same EHR, eCQMs will be more feasible.
If not, you must normalize and aggregate your data to enable eCQM analysis.
If you need to normalize and aggregate data from multiple EHRs to report eCQMs (as is the case with most ACOs):
You’ll need to ensure your reporting process, from documentation to data submission, is entirely electronic.
And you’ll need to ensure that your process is entirely ONC certified.
One non-electronic or uncertified link in the chain puts you at risk for an invalidated submission.
If your organization utilizes multiple EHRs, you must ensure your central data repository includes enough data to meet data completeness criteria.
For 2023, CMS requires you report 70% of each measure denominator. In 2024 that requirement is queued to increase to 75%.
If more than 30% of your data is inaccessible, your eCQM submissions will not be valid.
Consider your documentation standards and compliance:
To accurately assess your performance with eCQMs, it is not enough to have given the required care. Your providers have to document the care correctly using the required workflows and standards.
Common threats your documentation include:
Documentation workflows that vary between clinicians
Documentation that is part of a narrative, textual summary rather than discrete data in a limited field or entry box
Documentation that was not created from a standardized data set
Documentation that draws from a variety of different standardized data sets
Finally, consider the stability of your organization:
If your ACO is data-compliant today, will it be compliant tomorrow?
As you add providers and practices to your organization, you must re-address the issues outlined above to keep your quality measurement accurate and compliant.
If it fits, and continues to work in the future, eCQMs can be a solid and cost-effective solution for you.
Explore Your Options: MIPS CQMs
While your responses to the survey indicate that your organization may be a good candidate for eCQMs, you may want to explore your options with MIPS CQMs and a Qualified Registry as well.
With our help, ACOs like yours are gaining a previously unattainable view of their data, no matter the number of patients, providers, locations, or EHRs. Our platform allows you to diagnose challenges at any level, and your dedicated Mingle Health consultant will help you monitor your performance to increase your chances of earning shared savings.
Better yet, by not locking your data into one technology platform, our solution prepares your organization for whatever comes next, whether that’s FHIR, dQMs, or a new set of CMS requirements.
And with Mingle Health, your APP reporting workflow will be operational within 90 days.
