Quality Measures and Performance Standards

Narrative and Technical Specifications

2012 ACO GPRO Quality Reporting Materials

• ACO GPRO Web Interface User Manual [PDF, 2.43MB]

XML Specifications 

The PQRS-GPRO-ACO 2012 XML Specification [ZIP, 6.28MB] file includes the following:

• ACO GPRO XML to Excel 2010 - The Excel instructions provided in the XML specifications are for Excel 2007 and 2003. This document explains the steps that must be taken if Excel 2010 is used; there was a  change in how Excel uses XML mappings in 2010.
• ACO GPRO XML Specifications Release Notes [PDF, 105KB ] - UPDATED The Release Notes for the ACO GPRO XML Specifications provide information on changes between the draft specifications and the final specifications.
• Updated ACO GPRO XML Specifications [PDF, 1MB]  – UPDATED (Please see page 125, section 4.3.2, in the example on how to change the header if using Excel.)  This document provides information on how to use Extensible Markup Language (XML) files in the ACO GPRO web interface to export and import data.
  
• 2012 ACO Narrative Quality Measures Specifications Manual [PDF, 568KB] - This document provides guidance about the 33 required quality measures that are part of the quality performance standard, including the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience survey measures, claims-based measures, the Electronic Health Record (EHR) Incentive Program measure, and the required Group Practice Reporting Option (GPRO) web interface quality measures that are required for purposes of ACO participants earning a Physician Quality Reporting System (PQRS) incentive under the Medicare Shared Savings Program.
  
• ACO GPRO Supporting Documents July 2012 [ZIP, 749KB] - These documents provide the technical specifications for the ACO quality measures that will be reported using the Group Practice Reporting Option (GPRO) web interface.
  
• Beta Blockers for ACO #31 [PDF, 21KB] – This is an updated Beta-blocker list provided by the measure steward for Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD).
  
• The following documents provide the technical specifications for ACO claims-based and administrative measures:
  • • #8 Risk-standardized all condition readmission [PDF, 275KB]
    • #9 ACSC: Chronic Obstructive Pulmonary Disease and Asthma [PDF, 190KB]
    • #10 ACSC: Congestive Heart Failure [PDF, 188KB]
    • #11 Percent of PCPs who qualify for an EHR incentive payment [PDF, 202KB]
    • 
      
• 2013 Quality Performance Standards Narrative Measure Specifications [PDF, 807KB] -These specifications apply to quality measure data to be captured during 2013 by ACOs and ACO participants and reported in early 2014.  This document provides guidance about the 33 required quality measures that are part of the quality performance standard, including the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience survey measures, claims-based measures, the Electronic Health Record (EHR) Incentive Program measure, and the required Group Practice Reporting Option (GPRO) web interface quality measures that are required for purposes of ACO participants earning a Physician Quality Reporting System (PQRS) incentive under the Medicare Shared Savings Program.
  
• 2013 ACO Release Notes [PDF, 84KB]

•  

  CAHPS Documents

  • CG CAHPS for ACOs – Field Test Survey Content by Survey Domain Overview [PDF, 545KB] - This document provides information to ACO providers, participants and other stakeholders about the content and organization of the Clinician & Group CAHPS for Accountable Care Organizations Field Test Survey. 
  • CG CAHPS for ACOs - Final National Implementation Survey Content [PDF, 272KB] - This document provides information to ACO providers, participants and other stakeholders about the final content of the Clinician & Group CAHPS for Accountable Care Organizations National Implementation Survey used to report patient experience of care measures for the 2012 reporting period.

  Supplemental Documents

  • Guide to ACO Participation in the 2012 Physician Quality Reporting System and Electronic Prescribing Incentive Program [PDF, 134KB] - This document provides guidance about Medicare Shared Savings Program and Pioneer ACO participation in the 2012 Physician Quality Reporting System and Electronic Prescribing Incentive Program.
    
  • Guide to Quality Performance Standards for Accountable Care Organizations Starting in 2012: Pay for Reporting and Pay for Performance [PDF, 121KB] - This document provides information about two quality performance standards, pay for reporting and pay for performance for ACOs with a 2012 start date participating in the Medicare Shared Savings Program.
    
  • Guide to Quality Measurement for Accountable Care Organizations Starting in 2012: Agreement Period, Performance Year, and Reporting Period [PDF, 113KB] - This document provides clarification on the quality reporting timeframes and reporting requirements for ACOs with a 2012 start date participating in the Medicare Shared Savings Program.
    
  • Guide to Quality Scoring for Accountable Care Organizations [PDF, 78KB] – This provides guidance on quality performance scoring for Accountable Care Organizations.