CMS Proposes Additional ACO Quality Measures for 2015

A CMS proposal would increase the number of quality measures that accountable care organizations (ACOs) would have to achieve under the Medicare Shared Savings Program in 2015. The changes, which are included in the Medicare physician fee schedule, would introduce 4 additional quality performance benchmarks. ACOs receive bonus payments based on the number of quality targets they meet.

Specifically, the new targets would measure patient education about medication costs, the rate at which patients are admitted to a skilled-nursing facility within 30 days of hospital discharge, and the rate of “all-cause” unplanned readmissions for patients with chronic illnesses such as diabetes.

In addition, CMS proposed replacing a medication management measure, changing a requirement for electronic health records adoption, and removing another measure related to the treatment of coronary artery disease, diabetes, and ischemic vascular disease.

Blair Childs, spokesperson for Premier Healthcare Alliance, voiced particular comments about the EHR requirement: “… CMS’s proposal to reduce the reporting burden on ACOs and move toward electronic submission of measures is also a positive step. This will greatly simplify the reporting process, which today is labor intensive and based on manual chart abstractions. We also support CMS’s efforts to create more realistic benchmarks for ‘topped out’ measures with overall high-performance.”

CMS said it would continue to seek comments over the proposed changes. Officials seek input on future quality measures for care coordination, health outcomes, nursing home quality, prevention, elderly public health, and utilization. The number of ACO participants, which presently includes 350 organizations, is also expected to increase throughout next year.

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