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Timing of Quality Reporting Alignment at CMS

Posted by Matthew Smith on May 7, 2013 12:09:00 PM

CMS, ReportingIn order to reduce the burden of multiple quality reporting initiatives, CMS is working to align quality measurement across programs. As part of the eHealth initiative, CMS has created a timeline of quality measurement alignment for both eligible professionals (EPs) and eligible hospitals.

This timeline includes upcoming activities that CMS is taking or that EPs and eligible hospitals can take to prepare for this alignment.

For Eligible Hospitals
By 2013:

  • Complete alignment of Hospital Value-Based Purchasing (HVBP) and Inpatient Quality Reporting (IQR) Program CQMs reported on Hospital Compare.
  • Implement the Medicare EHR Incentive Program Electronic Reporting Pilot for Eligible Hospitals and Critical Access Hospitals. (Note: This electronic reporting pilot will be the basis for electronic reporting in other reporting programs.)

By 2014:

  • IQR will introduce EHR-based reporting. Additional details will be included in the Fiscal Year (FY) 2014 Inpatient Prospective Payment System proposed rule that is targeted for publication later this year.

Beyond 2014:

  • CQMs will be transitioned to electronic EHR-based reporting in the Medicare EHR Incentive Program, and then to IQR and other hospital reporting programs.

For EPs
By 2013:

  • Individual EPs: Implement the PQRS-EHR Incentive Program Pilot (Note: EPs can fulfill the CQM component of meaningful use for the Medicare EHR Incentive Program as well as PQRS if reported using QRDA I).

Group Practices:

  • Align PQRS Group Practice Reporting Option (GPRO) web interface CQMs with those in the ACO GPRO measure set and the Physician Value-Based Modifier (VBM) GPRO measure set.
  • Align PQRS with the VBM, whereby the quality component of the 2015 VBM for group practices with 100 or more EPs that elect quality tiering will be based on the groups' performance on PQRS measures.

By 2014:

  • Individual EPs: PQRS EHR reporting options align, including CQMs, reporting criteria, and reporting mechanism in the calendar year 2013 Physician Fee Schedule and the Stage 2 rules for the Medicare EHR Incentive Program.
  • Group Practices: Group practices participating in the PQRS GPRO or Medicare ACOs using certified EHR technology and reporting via the GPRO web interface fulfill the requirement of the CQM component of meaningful use for the EHR Incentive Programs.

Group practices can also report the CQMs as a group directly to CMS to fulfill the requirement of the CQM component of meaningful use for the EHR Incentive Program.

Learn more about quality program alignment efforts at CMS by visiting www.CMS.gov/eHealth.

Meaningful Use, Meaningful Use Incentives

Topics: EHR, CMS, PQRS, CQM, GPRO, Eligible Hospitals, Eligible Professionals

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