Timing of Quality Reporting Alignment at CMS 

by Kate Goodrich, Acting Director, Quality Measurement and Health Assessment Group

In aligning quality measurement across programs for the eHealth initiative, CMS has created a timeline for both eligible professionals (EPs) and eligible hospitals.

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 Schedule proposed rule that is targeted for publication in the spring of 2013.

Beyond 2014:
CQMs will be transitioned to EHR-based reporting in the EHR Incentive Program and then to IQR and other hospital reporting programs.

For Eligible Professionals:
By 2013:

  • Individual EPs: Implement the PQRS-EHR Incentive Program Pilot (Note: EPs can fulfill the CQM component of meaningful use 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 VBM GPRO measure set.
    • Align PQRS with the Physician Value-Based Modifier (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 (CY) 2013 Physician Fee Schedule (PFS) and the Stage 2 rules.
  • Group Practices: Group practices participating in the PQRS GPRO or 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 Program.
    • 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.