The "Health Care Efficiency Through Flexibility Act" aims to enhance quality reporting under the Medicare Shared Savings Program. It mandates the availability of various collection types, such as electronic and MIPS clinical quality measures, for performance years 2025–2029. Additionally, a pilot program for digital quality measure reporting is established for 2028–2032, offering ACOs the opportunity to report specified quality measures through digital collection types. The program selects participating ACOs and provides technical assistance, with the requirement for the Secretary to publicly post an analysis of the program and proposed timeline for broader implementation.
Health Care Efficiency Through Flexibility Act
This bill delays certain requirements relating to the reporting of quality measures by accountable care organizations (ACOs) under the Medicare Shared Savings Program. It also requires the Centers for Medicare & Medicaid Services (CMS) to establish a pilot program that tests alternative digital reporting methods for ACOs.
The Medicare Shared Savings Program enables ACOs to receive payments for savings stemming from care coordination and management. In 2024, the CMS issued a rule requiring ACOs to report on quality measures using a certain electronic system beginning in 2025.
The bill allows ACOs to continue to use prior methods of reporting quality measures through 2029. Additionally, the CMS must establish a pilot program to test other digital reporting methods from 2028-2032; ACOs that participate in the pilot program are exempt from using other methods. The CMS must publicly post an analysis of the program and any related recommendations for using the tested methods.