AMIA Welcomes Flexibility in CMS Quality Reporting and Quality Payment Programs

by | Last updated May 15, 2023 | Published on Jun 27, 2017 | Healthcare News

Amia Supports Quality Reporting
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If implemented correctly, electronic health record (EHR) based automated quality measure reporting can ease quality reporting and improve access to real-time data to promote quality improvement. EHRs also improve the delivery of medical billing and coding services with accurate documentation. Every year, the Centers for Medicare & Medicaid Services (CMS) updates the electronic clinical quality measures (eCQMs) for inclusion in CMS quality reporting programs. As they include new codes, logic corrections, and clarifications, CMS requires eligible clinicians and hospitals to implement and use the updates. Based upon data collected by CMS, 95 percent of hospitals currently attest to successful eCQM reporting under the Medicare and Medicaid EHR Incentive Programs.

According to a recent Health Data Management report, the American Medical Informatics Association (AMIA) supports the electronic health records provisions that CMS proposed in April as part of a major rule covering hospital inpatient and long-term care hospital prospective payment systems for Fiscal Year 2018.

The requirements of the CMS IQR program in 2017 were:

  • Hospitals must choose eight of 15 available eCQMs to report electronically
  • Hospitals must report on eCQMs for ALL FOUR quarters of 2017
  • Submission should be completed by February 28, 2018
  • The files that the hospital submits for its 2017 data are required to use EHR technology certified to the 2015 Edition of CEHRT
  • Data from that period must be submitted in a QRDA I file format

The flexibilities that CMS proposed in April include:

  • A 90-day EHR Incentive Program reporting period
  • Reduction of required quality measures from eight to six
  • Flexibility to submit two self-selected quarters of data, a significant reduction from the previous requirement of one full year of data

Another proposed measure that the AMIA is upbeat about is the alignment of hospital reporting requirements with eligible professional requirements for the Merit-based Incentive Payment System requirements. This will minimize burden and confusion.

As many providers have still not updated to the 2015 edition of meaningful use EHRs, AMIA expects that the 90-day EHR Incentive Program reporting period will give them more time to implement and modify workflows, and upgrade and fully implement 2015 Certified Electronic Health Record Technology (CEHRT).

CMS proposes to stick to the requirement that EHRs be certified to the 2015 Edition of meaningful use for clinical quality measures reporting. However, the agency also recommends that it is not necessary that such EHRs are recertified each time the EHR is updated to a more recent version of the quality measures. AMIA agrees with CMS that the certification and upgrades will allow eligible professionals and hospitals to successfully attest for an EHR reporting period in 2018.

Another proposal that CMS has put forward is changing the reporting period for eligible professionals reporting clinical quality measures electronically in the Medicaid EHR Incentive program to a minimum of a continuous 90-day period during calendar year 2017. Eligible professionals opting to attest instead of reporting electronically and who have previously demonstrated meaningful use would report for the full year.

One concern that AMIA has raised is about ICD-10 coding update proposals. AMIA notes that the meaning of a code should not change over as this could obstruct consistent clinical vocabulary maintenance.

Dedicated to collecting, analyzing and applying data directly to care decisions, AMIA helps stakeholders improve outcomes, lower costs, increase safety and promote the use of high-quality services. AMIA goal is to ensure that EHRs and information technology are used most effectively to enhance medical care and advance the functionality of EHRs.

Fully-integrated electronic health records (EHR), practice management and billing services solutions come with a host of features to support practices of all sizes. When used correctly, Electronic Health Records (EHRs) can result in more accurate documentation leading to more complete coding, and ultimately, more accurate reimbursement claims. While today’s EHR systems automatically create and assign procedure and diagnosis codes, reliable medical coding services are critical to ensure accurate claim submission. In leading companies, medical coders are at the forefront of health IT. Experts at handling the voluminous data that EHRs generate, they review the automatically generated codes and ensure that they are compliant with the latest CMS quality reporting guidelines and private payer rules.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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