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eCQMs: Beginning of a Long and Rocky Road

by Matt Guldin | September 26, 2014

A New Necessity

Payment-based upon quality measurement is at the center of a wide range of efforts to improve health care performance by various payers including the federal government. Historically, quality measurement either had to rely upon either administrative data (e.g., claims) and/or a combination of manual chart abstraction.

Electronic clinical quality measures (eCQMs) derived from EHRs have been touted as a way to effectively scale the growing requirements for quality management program. Starting in CY/FY 2014, eligible providers in the EHR Incentive program beyond their first year of MU participation will have to submit a select number of eCQMs to CMS in order to successfully attest. Providers who fail to successfully attest will be subject to payment reductions of one percent in 2015, two percent in 2016, and three percent in 2017. eCQMs are also being utilized as a method for providers to submit quality data for other federal programs including the Hospital Inpatient Reporting Program and the Physician Quality Reporting System.

The Office of the National Coordinator for Health Information Technology (ONC) certifies that EHR technologies are capable of accurately calculating the eCQM results for the EHR incentive program. Initial findings though have found several issues with abstracting, calculating, and submitting eCQMs.

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