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© 2024 Health Catalyst Inc. All Rights Reserved.
Empowering ACOs:
Leveraging Quality Management Tools for MIPS and Beyond
Shannon Campbell and Hazel Morrison
Agenda
© 2024 Health Catalyst Inc. All Rights Reserved.
 Regulatory Requirements for ACOs
 How to avoid common pitfalls for
ACOs
 Using MeasureAble for MIPS and
beyond
© 2024 Health Catalyst Inc. All Rights Reserved.
Regulatory
Requirements for
ACOs
© 2024 Health Catalyst Inc. All Rights Reserved.
Poll Question # 1
• Annually
• Quarterly
• Monthly
• Actively/continuously
How actively do you monitor your quality performance throughout the year?
© 2024 Health Catalyst Inc. All Rights Reserved.
Intent of Quality Payment Program
© 2024 Health Catalyst Inc. All Rights Reserved.
Intent of Quality Payment Program
Culture of continuous monitoring of performance.
Don't simply engage in the measures during the
submission period.
• Waste of investment in EHR and data collection.
• Risks patient outcomes.
Do monitor performance throughout the calendar year.
• Identify and close gaps before submission.
• Improve patient care.
• Provide control over measure scores and financial
incentives.
Why ACOs should embrace a culture that aligns with QPP:
• Closure of performance gaps
• Improve scores
• More agile
• Better equipped to adjust to CMS changes
• Maximize financial incentives
• Data sharing among organizations within the ACO
o Supporting the continuum of care
o Shared accountability for patient care
© 2024 Health Catalyst Inc. All Rights Reserved.
Poll Question # 2
• We do not have care gap closure processes. We submit the data to CMS.
• We notify member organizations about care gaps.
• We identify patterns in care gaps and provide member organizations with insights for
improvement.
• We actively work with member organizations to improve their processes related to care
gaps.
• Other
How actively do you manage performance?
© 2024 Health Catalyst Inc. All Rights Reserved.
ACO Submission Options
CY2021 PFS Final Rule aligned MSSP with MIPS, shifting MSSP ACOs from quality data
submission via CMS Web Interface to Traditional MIPS methods.
(CMS Web Interface will sunset at end of 2024 performance period; unavailable as of 2025 performance period)
Medicare patients
© 2024 Health Catalyst Inc. All Rights Reserved.
ACO Submission Options
Optional for 2021 through 2024 performance period
CMS Web Interface will sunset at the end of 2024
Required for 2025 performance period
CQMs/Medicare CQMs/eCQMs
All patients, regardless of
payer.
(Medicare, Medicaid,
commercial, self-pay, etc.)
© 2024 Health Catalyst Inc. All Rights Reserved.
Data Completeness for ACOs
At the measure level
© 2024 Health Catalyst Inc. All Rights Reserved.
ACO Performance Categories and Weighting
*Categories and weights differ for ACO MIPS eligible clinicians who aren't QPs & may be required to submit MIPS.
CY2024 PFS Rule change:
2024: Qualified Participants (QPs) and
Partial QPs exempt from PI
2025: QPs and Partial QPs must submit PI
(either at the ACO level or other)
© 2024 Health Catalyst Inc. All Rights Reserved.
MSSP ACO Performance Categories and Weighting
*Categories and weights differ for ACO MIPS eligible clinicians who aren't QPs & may be required to submit MIPS.
© 2024 Health Catalyst Inc. All Rights Reserved.
MSSP ACO Participant Performance Categories and Weighting
© 2024 Health Catalyst Inc. All Rights Reserved.
Common Questions
and Concerns
© 2024 Health Catalyst Inc. All Rights Reserved.
FAQs
What is the intention of data completeness?
CQMs
(and now Medicare CQMs)
2017 performance year: 50%
2018 performance year: 60%
2019 performance year: 60%
2020 performance year: 70%
2021 performance year: 70%
2022 performance year: 70%
2023 performance year: 70%
2024 performance year: 75%
2025 performance year: 75%
2026 performance year: 75%
eCQMs
No data completeness requirement.
The electronic collection method inherently has a
data completeness rate of 100%.
© 2024 Health Catalyst Inc. All Rights Reserved.
FAQs
Does the eCQM/CQM reporting incentive also apply to Medicare CQMs?
No, it does not.
The reporting incentive applies to all payer/all patient reporting.
Medicare CQMs only include Medicare beneficiaries, so they are not
eligible for the incentive.
© 2024 Health Catalyst Inc. All Rights Reserved.
Using MeasureAble
for MIPS and Beyond
© 2024 Health Catalyst Inc. All Rights Reserved.
Poll Question # 3
• I have never seen a MeasureAble dashboard.
• I have seen a demo, but I have never used MeasureAble.
• I use MeasureAble to track performance.
• I use MeasureAble today to track performance and to submit.
How familiar are you with the MeasureAble product?
© 2024 Health Catalyst Inc. All Rights Reserved.
Stepping Up the Value of Measures
Regulatory
Improvement
Compensation
Insights
Streamlined
workflows to submit
data to meet
requirements
Analytics help you
understand the
reasons behind your
quality scores
Tools support
improvement work to
provide better care
and increase your
quality scores
Reduced penalties
and increased
bonuses based on
improvement in your
quality scores
© 2024 Health Catalyst Inc. All Rights Reserved.
Using MeasureAble to Gain Insights for Improvement
Program Summary
Groups
Providers
Patients
Patient Record
 Monitor and manage
performance with 5 simple
screens
 Gain actionable-insights
using color-coding to
improve and close gaps-in-
care
 Drill down from summary
view to patient level for
root-cause analysis
© 2024 Health Catalyst Inc. All Rights Reserved.
Poll Question # 4
• We do not plan to submit at the ACO level.
• We plan to submit traditional CQMs.
• We plan to submit Medicare CQMs.
• We plan to submit eCQMs.
• We plan to submit via the CMS web interface.
What are your submission plans for Performance Year 2024?
© 2024 Health Catalyst Inc. All Rights Reserved.
Viewing and Tracking Quality Performance
© 2024 Health Catalyst Inc. All Rights Reserved.
Submission through Able Health Qualified Registry
1. Use the Actions menu to open the submission
wizard.
2. You will be guided through a step-by-step process
of filling out all the configurations and
attestations needed for your submission.
3. You can use the submission wizard to submit via
the Able Health qualified registry.
4. Once the submission is complete, you can
download all documentation related to your
submission.
© 2024 Health Catalyst Inc. All Rights Reserved.
Submission through QRDA III Export
1. Use the Actions menu to export QRDA III file(s).
2. You will be emailed a secure link to download the QRDA III
files.
3. Log into the QPP web portal using a HARP account.
4. Upload the QRDA III files to the QPP web portal.
5. Use the MeasureAble submission wizard to submit PI
measures.
© 2024 Health Catalyst Inc. All Rights Reserved.
Promoting Interoperability
© 2024 Health Catalyst Inc. All Rights Reserved.
Improvement Activities and Cost
© 2024 Health Catalyst Inc. All Rights Reserved.
Estimating Your Composite Score
© 2024 Health Catalyst Inc. All Rights Reserved.
Resources for MSSP ACO Quality Reporting
APP Quality Requirements (MSSP ACOs)
MSSP: Reporting MIPS CQMs and eCQMs in the APP
2024 MIPS Quality Measures List
2024 MIPS Quality Measure Specifications
2024 Medicare CQM Specifications
2024 Medicare CQM Checklist
2024 MIPS Quality Data Completeness Quick Guide
Questions?
© 2024 Health Catalyst Inc. All Rights Reserved.
Presenters
Shannon Campbell | Sr. Manager of Regulatory Measures Program
Hazel Morrison | MeasureAble Product Manager
Host
Alora Martin | Webinar Program Manager
hcwebinars@healthcatalyst.com
© 2024 Health Catalyst Inc. All Rights Reserved.
Thank You!

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Empowering ACOs: Leveraging Quality Management Tools for MIPS and Beyond

  • 1. © 2024 Health Catalyst Inc. All Rights Reserved. Empowering ACOs: Leveraging Quality Management Tools for MIPS and Beyond Shannon Campbell and Hazel Morrison
  • 2. Agenda © 2024 Health Catalyst Inc. All Rights Reserved.  Regulatory Requirements for ACOs  How to avoid common pitfalls for ACOs  Using MeasureAble for MIPS and beyond
  • 3. © 2024 Health Catalyst Inc. All Rights Reserved. Regulatory Requirements for ACOs
  • 4. © 2024 Health Catalyst Inc. All Rights Reserved. Poll Question # 1 • Annually • Quarterly • Monthly • Actively/continuously How actively do you monitor your quality performance throughout the year?
  • 5. © 2024 Health Catalyst Inc. All Rights Reserved. Intent of Quality Payment Program
  • 6. © 2024 Health Catalyst Inc. All Rights Reserved. Intent of Quality Payment Program Culture of continuous monitoring of performance. Don't simply engage in the measures during the submission period. • Waste of investment in EHR and data collection. • Risks patient outcomes. Do monitor performance throughout the calendar year. • Identify and close gaps before submission. • Improve patient care. • Provide control over measure scores and financial incentives. Why ACOs should embrace a culture that aligns with QPP: • Closure of performance gaps • Improve scores • More agile • Better equipped to adjust to CMS changes • Maximize financial incentives • Data sharing among organizations within the ACO o Supporting the continuum of care o Shared accountability for patient care
  • 7. © 2024 Health Catalyst Inc. All Rights Reserved. Poll Question # 2 • We do not have care gap closure processes. We submit the data to CMS. • We notify member organizations about care gaps. • We identify patterns in care gaps and provide member organizations with insights for improvement. • We actively work with member organizations to improve their processes related to care gaps. • Other How actively do you manage performance?
  • 8. © 2024 Health Catalyst Inc. All Rights Reserved. ACO Submission Options CY2021 PFS Final Rule aligned MSSP with MIPS, shifting MSSP ACOs from quality data submission via CMS Web Interface to Traditional MIPS methods. (CMS Web Interface will sunset at end of 2024 performance period; unavailable as of 2025 performance period) Medicare patients
  • 9. © 2024 Health Catalyst Inc. All Rights Reserved. ACO Submission Options Optional for 2021 through 2024 performance period CMS Web Interface will sunset at the end of 2024 Required for 2025 performance period CQMs/Medicare CQMs/eCQMs All patients, regardless of payer. (Medicare, Medicaid, commercial, self-pay, etc.)
  • 10. © 2024 Health Catalyst Inc. All Rights Reserved. Data Completeness for ACOs At the measure level
  • 11. © 2024 Health Catalyst Inc. All Rights Reserved. ACO Performance Categories and Weighting *Categories and weights differ for ACO MIPS eligible clinicians who aren't QPs & may be required to submit MIPS. CY2024 PFS Rule change: 2024: Qualified Participants (QPs) and Partial QPs exempt from PI 2025: QPs and Partial QPs must submit PI (either at the ACO level or other)
  • 12. © 2024 Health Catalyst Inc. All Rights Reserved. MSSP ACO Performance Categories and Weighting *Categories and weights differ for ACO MIPS eligible clinicians who aren't QPs & may be required to submit MIPS.
  • 13. © 2024 Health Catalyst Inc. All Rights Reserved. MSSP ACO Participant Performance Categories and Weighting
  • 14. © 2024 Health Catalyst Inc. All Rights Reserved. Common Questions and Concerns
  • 15. © 2024 Health Catalyst Inc. All Rights Reserved. FAQs What is the intention of data completeness? CQMs (and now Medicare CQMs) 2017 performance year: 50% 2018 performance year: 60% 2019 performance year: 60% 2020 performance year: 70% 2021 performance year: 70% 2022 performance year: 70% 2023 performance year: 70% 2024 performance year: 75% 2025 performance year: 75% 2026 performance year: 75% eCQMs No data completeness requirement. The electronic collection method inherently has a data completeness rate of 100%.
  • 16. © 2024 Health Catalyst Inc. All Rights Reserved. FAQs Does the eCQM/CQM reporting incentive also apply to Medicare CQMs? No, it does not. The reporting incentive applies to all payer/all patient reporting. Medicare CQMs only include Medicare beneficiaries, so they are not eligible for the incentive.
  • 17. © 2024 Health Catalyst Inc. All Rights Reserved. Using MeasureAble for MIPS and Beyond
  • 18. © 2024 Health Catalyst Inc. All Rights Reserved. Poll Question # 3 • I have never seen a MeasureAble dashboard. • I have seen a demo, but I have never used MeasureAble. • I use MeasureAble to track performance. • I use MeasureAble today to track performance and to submit. How familiar are you with the MeasureAble product?
  • 19. © 2024 Health Catalyst Inc. All Rights Reserved. Stepping Up the Value of Measures Regulatory Improvement Compensation Insights Streamlined workflows to submit data to meet requirements Analytics help you understand the reasons behind your quality scores Tools support improvement work to provide better care and increase your quality scores Reduced penalties and increased bonuses based on improvement in your quality scores
  • 20. © 2024 Health Catalyst Inc. All Rights Reserved. Using MeasureAble to Gain Insights for Improvement Program Summary Groups Providers Patients Patient Record  Monitor and manage performance with 5 simple screens  Gain actionable-insights using color-coding to improve and close gaps-in- care  Drill down from summary view to patient level for root-cause analysis
  • 21. © 2024 Health Catalyst Inc. All Rights Reserved. Poll Question # 4 • We do not plan to submit at the ACO level. • We plan to submit traditional CQMs. • We plan to submit Medicare CQMs. • We plan to submit eCQMs. • We plan to submit via the CMS web interface. What are your submission plans for Performance Year 2024?
  • 22. © 2024 Health Catalyst Inc. All Rights Reserved. Viewing and Tracking Quality Performance
  • 23. © 2024 Health Catalyst Inc. All Rights Reserved. Submission through Able Health Qualified Registry 1. Use the Actions menu to open the submission wizard. 2. You will be guided through a step-by-step process of filling out all the configurations and attestations needed for your submission. 3. You can use the submission wizard to submit via the Able Health qualified registry. 4. Once the submission is complete, you can download all documentation related to your submission.
  • 24. © 2024 Health Catalyst Inc. All Rights Reserved. Submission through QRDA III Export 1. Use the Actions menu to export QRDA III file(s). 2. You will be emailed a secure link to download the QRDA III files. 3. Log into the QPP web portal using a HARP account. 4. Upload the QRDA III files to the QPP web portal. 5. Use the MeasureAble submission wizard to submit PI measures.
  • 25. © 2024 Health Catalyst Inc. All Rights Reserved. Promoting Interoperability
  • 26. © 2024 Health Catalyst Inc. All Rights Reserved. Improvement Activities and Cost
  • 27. © 2024 Health Catalyst Inc. All Rights Reserved. Estimating Your Composite Score
  • 28. © 2024 Health Catalyst Inc. All Rights Reserved. Resources for MSSP ACO Quality Reporting APP Quality Requirements (MSSP ACOs) MSSP: Reporting MIPS CQMs and eCQMs in the APP 2024 MIPS Quality Measures List 2024 MIPS Quality Measure Specifications 2024 Medicare CQM Specifications 2024 Medicare CQM Checklist 2024 MIPS Quality Data Completeness Quick Guide
  • 29. Questions? © 2024 Health Catalyst Inc. All Rights Reserved. Presenters Shannon Campbell | Sr. Manager of Regulatory Measures Program Hazel Morrison | MeasureAble Product Manager Host Alora Martin | Webinar Program Manager hcwebinars@healthcatalyst.com
  • 30. © 2024 Health Catalyst Inc. All Rights Reserved. Thank You!

Editor's Notes

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