Keys to successful ACO quality reporting

Mike Camacho | President, SLTCM

Tom Kim, MD | Chief Medical Officer, SLTCM 

In January of 2023, Sound Long-Term Management (SLTCM) launched as an accountable care organization (ACO) focused on caring for Medicare beneficiary residents in long-term care facilities. Navigating the reporting landscape was a challenge and was only achieved after mastering a framework for quality metrics that is sustainable for both the ACO and our patients. 

SLTCM takes part in the Medicare Shared Savings Program (MSSP) which allows multiple ways for providers partnered with our the ACO to report quality metrics to Centers for Medicare and Medicaid Services (CMS). To submit the three measures of HbA1C Poor Control, Screening for Depression, and Follow-Up and Control of High Blood Pressure, one of these three models are used for reporting: 

• eCQM: Electronic clinical quality measures are measures that track the quality of health care provided by using data from electronic health records and health information technology. 
• MIPS CQM: Merit-based incentive pay system clinical quality measures are more flexible and take quality, improvement activities, promoting interoperability, and cost into account. 
• Web-Interface reporting: CMS requires 10 quality metrics to be reported on a randomized percentage of the total assigned ACO population. This model is going away beginning in 2025 and ACOs participating in the MSSP will be required to report on eCQM/CQM MIPS.2 

Sound Long-Term Care Management perused MIPS CQM reporting and outlined three keys to success:

1. Select the right vendors. 
   • SLTCM championed vendors with experience and educational resources. Bringing on Mingle Health as reporting registry and MarMacKee Consulting as a contracted educator gave us the best allies in quality metrics. 
2. Create a plan to collect quality data 
   • A biweekly recording cadence kept participating clinical leadership teams in step with the rest of SLTCM. Dedicated account management and working with vendors directly allowed data collection directly from the EMR. 
3. Track Performance 
   • A performance dashboard was created for every participating group and weekly targets were monitored. The group’s accountability was reflected in their quality reporting. 

Having a dedicated team focused on quality reporting was the best thing for our first-year ACO. The coordination and analysis of data was vital to ensuring our partners received the credit they deserved for the amazing care they provided. 

CMS recently added a new option to report CQMs called Medicare CQMs.  This changes to the requirement from all payers/all patient reporting to reporting on just Medicare beneficiaries. We at Sound Long-Term Care Management are excited about this new focused approach. We’re well-positioned to report quality in 2024 with the new Medicare CQMs pathway. 

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