On April 11, the leaders of the Washington, D.C.-based NAACOS, the National Association of ACOs, which represents the interests of accountable care organizations nationwide, announced that they were launching a new task force for the industry. The press release began thus: “Today, the National Association of ACOs (NAACOS) announced it has launched a new task force, aimed at developing recommendations for how to successfully collect and electronically report on ACOs’ quality of care through disparate health information technology (IT) systems. The Centers for Medicare and Medicaid Services (CMS) has made it a goal to fully move to digital quality measurement by 2025.”
Indeed, the press release went on, “That goal remains elusive for ACOs, who sometimes work with dozens of electronic health record (EHR) systems and must combine data from a myriad of doctors’ offices, hospitals, and other providers not using the same EHR. While CMS has delayed the transition to electronic clinical quality measures (eCQMs) until 2025, ACOs will need this time to develop solutions to the obstacles that currently exist to make a successful transition.”
The press release quoted Katherine Schneider, M.D., chair of the NAACOS Digital Quality Measurement Task Force and past NAACOS board chair, as stating that “Our EHR systems today have not yet achieved the real-world interoperable state needed to easily combine non-standardized patient data from various providers, a future requirement of CMS’s quality reporting for Medicare Shared Savings Program (MSSP) ACOs.”
Further, the press release stated, “In addition to cost savings, ACOs are incentivized to demonstrate high quality of care on their assigned patients. ACOs are evaluated on a number of quality measures, such as patient experience, the delivery of flu vaccines, cancer screenings, and diabetes control. Participants in the MSSP, CMS’s largest and most successful value-based care program, received an average quality score of 97.8 percent in 2020, a new program best. The NAACOS Digital Quality Measurement Task Force will convene ACO leaders and other experts to identify current capabilities and obstacles, helping generate potential solutions and recommendations that will be published in a policy paper later this year. It will then gather stakeholders, including CMS, the Office of the National Coordinator for Health IT (ONC), and health IT vendors, to discuss and react to the policy recommendations. “
“ACOs have broader concerns about the eCQM program as currently constructed, especially many unintended implications and consequences of mandating data reporting on total patient populations instead of just the MSSP as has been done since program inception a decade ago,” Schneider said. “Nonetheless, we know digital quality reporting in general is the direction we need to move in, but we need to get it right, ultimately for the benefit of the momentum of value-based care and for patients, including those cared for by safety net providers. As of today, digital quality reporting presents major financial and operational challenges, requiring significant investment by vendors, practices, and ACOs for readiness according to the current timeline.”
According to a NAACOS survey last year, more than three-quarters of ACOs have six or more EHRs, and 37 percent have 15 or more EHRs. Many rely on third-party companies to help them aggregate data, adding to the cost of their work.
Members of the task force include:
• Maria Alexander, Mount Sinai
• Jim Barr, MD, Atlantic ACO
• Lindsey Bryan, The Ohio State Health ACO
• Paula Burleson, Novant Health
• Aaron Clark, DO, The Ohio State Health ACO
• Rob Fields, MD, Mount Sinai
• Chris Elfner, Bellin Health Partners ACO
• Josh Israel, MD, Aledade
• Jessica Landin, Evolent Health
• Stephen Nuckolls, Costal Carolina Quality Care
• Ashish Parikh, MD, Summit Health
• Megan Reyna, Advocate Aurora Health
• Anna Taylor, MultiCare Connected Care
• Jessica Walradt, Northwestern Medicine
