House Passes Bill to Ease Quality Reporting Requirements for Medicare ACOs

Physician practices participating in a Medicare accountable care organization (ACO) may have an easier time submitting quality data to Medicare if a bill passed Monday by the House becomes law.

H.R. 5347, the Health Care Efficiency Through Flexibility Act, would allow Medicare ACOs to continue to collect quality data through three types of measures — electronic clinical quality measures (eCQMs), Merit-Based Incentive Payment System clinical quality measures, and Medicare clinical quality measures — through performance year 2029. Previously, ACOs were supposed to begin using only eCQMs starting last year, according to a regulation issued by CMS in 2024.

The bill applies specifically to the Medicare Shared Savings Program, one of the more popular forms of Medicare ACOs. ACOs are groups of doctors, hospitals, and other healthcare professionals that work together to give patients high-quality, coordinated service and healthcare, improve health outcomes, and manage costs, according to CMS.

The measure, which was passed by a voice vote, also requires CMS to establish a pilot program to test other digital reporting methods for ACOs. The pilot program, which would run from 2028 to 2032, would exempt ACOs that participate in it from using other reporting methods; once it ends, CMS would be required to publicly post an analysis of the program and any related recommendations.

“By ensuring ACOs have access to multiple quality reporting pathways, my bipartisan legislation will reduce excess regulatory burden on ACOs and allow providers to focus on delivering high-quality, value-based care,” Rep. Vern Buchanan (R-Fla.), said Monday in a statement. “I look forward to my bill being considered by my Senate colleagues and ensuring that it is signed into law to improve care, lower costs, and make life easier for patients and doctors alike.” Buchanan chairs the House Ways and Means Health Subcommittee.

“Medical providers, including those participating in accountable care organizations, should not be distracted from providing better healthcare at a lower cost by uncertain Washington reporting rules,” Ways and Means Committee Chairman Jason Smith (R-Mo.) said in a statement. “The Health Care Efficiency Through Flexibility Act puts patient care first by giving medical providers the stability and flexibility to report quality measures the way that suits them best and ensure a smooth transition to digital reporting methods. This policy is particularly helpful for small, rural, and independent physician practices who often lack the sophisticated software needed to comply with the digital reporting regime but are successful value-based care providers.”

The measure had three Republican co-sponsors — Reps. Dan Crenshaw of Texas, Darin LaHood of Illinois, and Mike Lawler of New York — and one Democratic co-sponsor, Rep. Jimmy Panetta of California. It also is supported by the National Association of Accountable Care Organizations, America’s Physician Groups, Accountable for Health, and the Healthcare Information and Management Systems Society.

“We are very happy about the House passage of the H.R. 5347, as we have been advocating enthusiastically for its passage for some months,” Susan Dentzer, president and CEO of America’s Physician Groups, which represents physician-led ACOs, said in an email to MedPage Today. “We believe that measuring quality in healthcare and reporting on appropriate quality measures is vital to the success of value-based care, in which all our more than 300 physician member organizations are engaged. And we do believe that — beyond the vitally important question of which quality measures should be collected — the future surely lies in doing so through electronic or digital quality measures.”

“However, the state of play now for many Medicare Shared Savings Plan ACOs — in which many of our members participate — is that much of the healthcare system isn’t yet ready to report quality data to CMS using electronic clinical quality measures,” she continued. “The data needed to support these measures must be collected and reported right out of electronic health records, and not all [electronic health record] systems are currently configured to collect the specified measure data appropriately … It’s just a matter of common sense to give ACOs temporary flexibility (through performance year 2029) to choose one of three appropriate channels for reporting quality data while all Medicare Shared Savings Plan ACOs work toward the eventual goal of full implementation of eCQMs,” especially smaller, newer ACOs.

America’s Physician Groups also supports the pilot program mentioned in the legislation, she added. “In principle, we are fully supportive of the long-term push toward eCQMs, but it will be very helpful to test the approach broadly to surface any other issues that must be addressed before all ACOs use them as the sole quality reporting mechanism.”

Accountable for Health, an accountable care advocacy group, also praised the bill’s passage. “Overly rigid quality reporting requirements can divert time and resources away from patient care,” Mara McDermott, the organization’s CEO, said in a statement. “This bill takes a practical step by preserving flexibility in how ACOs report quality measures while the healthcare system continues its transition toward digital quality measurement.”

“By maintaining multiple quality reporting options through 2029 and supporting a thoughtful path toward more modern reporting systems, the legislation recognizes both the promise of digital innovation and the realities of today’s health IT infrastructure,” McDermott said. “ACOs want to be held accountable for quality and outcomes, but reporting requirements must be workable, consistent, and designed to support participation in accountable care.”

Currently, the House bill does not have a companion measure in the Senate; however, observers have suggested that it could be included in a year-end budget reconciliation package.

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