Roji Health Intelligence

Navigate The Path To Better Health Care.

by on

Customized Roji APP Reporting Plan Cuts ACO Costs and Burden, Boosts ACO Capabilities

image_pdfView PDFimage_printPrint

Roji’s customized APP Reporting Plan enables your ACO to meet highest quality Medicare APP reporting standards through our qualified registry, to meet Value-Based Care, while dramatically reducing reporting costs and creating actionable data.

Start your APP Reporting of Medicare CQMs and save with Roji Health Intelligence’s customized APP Reporting Plan for ACOs. Our new service enables your ACO to meet the highest quality reporting standards through our qualified registry, while dramatically reducing reporting costs and creating actionable data for use in population health, equity, and cost performance.

What’s at Stake for Large ACOs?

The finalized Medicare PFS Rule released in November 2023 toppled a big barrier for 2024 ACO quality reporting. CMS provided an option to allow ACOs to report measures for Medicare patients only—and of most importance, created the avenue to identify eligible patients for ACOs and potentially avoid aggregating data in 2024 or beyond. Data aggregation has been an issue for ACOs because of cost and EHR capabilities. CMS clearly realized that many ACOs were composed of practices with systems that lacked data exporting capabilities, and further mandated ACOs to require that their practices adopt certified EHRs in the future.

But APP Reporting through Medicare CQMs has limited potential; that process primarily benefits small ACOs. While smaller ACOs can manually gather data to populate measure results (using a qualified registry reporting application), this is not feasible for larger organizations. The three APP measures will have thousands of eligible patients, making manual data abstraction very difficult.

Roji’s customized solution uses CMS patient lists to populate patients in measures and then aggregates data where possible to capture measure numerator data. Our approach focuses on doing what is feasible. It deeply discounts data aggregation costs while allowing your ACO to get started with APP Reporting under less stress and with greater incentives.

Benefits to Roji’s Customized Plan for APP Reporting of Medicare CQMs

Here’s how Roji’s customized plan for APP Reporting of Medicare CQMs works to benefit ACOs and enables your organization to start reporting in 2024:

  • Significant savings on fees for APP quality reporting under Roji’s blended approach, which reduces fees to less than 30 percent of the all-patient data aggregation cost, and even more for larger ACOs with limited EHR systems.
  • Immediate ability for ACO to use aggregated data in population health and other improvements, by identifying all Medicare patients with poor results.
  • Easier startup to APP Reporting with relaxed performance standards and additional bonus points available in 2024, before APP becomes mandatory.
  • Lower threshold for success for APP Reporting. When reporting via the APP, an ACO may achieve just the 10th percentile on one of the outcome measures and still meet the quality performance standard.
  • Additional quality points through the Health Equity Adjustment for ACOs reporting through the APP.

How the Customized Roji Plan Works

  • CMS sends a quarterly upload of patients who are eligible for Medicare CQMs, based on the measure specifications and beneficiary attribution. By February of 2025, the list will include all denominator-eligible patients for 2024 (a departure from the Proposed Rule.) For most ACOs, this file will be too large for data abstraction of measure results, especially the final quarter to be delivered during the submission period.
  • Roji provides method for practices or ACOs to securely submit basic files (with Roji assistance) from EHRs to sync with CMS data, and obtain measure results without burdening practices. Roji uploads this data into our technology for ACO and practice view, accessible at any time. Results are updated throughout the year, so that your ACO can identify opportunities for improvement, whether they are related to clinical outcomes, costs or clinic-level data collection.
  • Roji provides our input application for practices to provide measure data directly from the EHR throughout the year, for practices where no data aggregation can occur or at the end of the reporting period.
  • Roji uploads aggregated results to the CMS scoring engine. Once results are calculated, Roji creates and transmits files to the CMS measure engine in the CMS-specified method, which ensures that your results are received and scored.

Start Your APP Reporting Efforts at Low Cost This Year

Historical ACO results have shown consistently that ACOs with more experience tend to perform better than those without. With the CMS Web Interface ending its run, it is imperative that you take this lesson to heart. Quality is scored comparatively, and those who take the first APP step before it becomes mandatory have the opportunity to fine-tune their process, giving them an inherent advantage over their peers. Begin the transition now to ensure that you can achieve the Quality Performance Standard and earn Shared Savings in the future. Contact us to learn more.

Founded in 2002, Roji Health Intelligence guides health care systems, providers and patients on the path to better health through Solutions that help providers improve their value and succeed in Risk.

Image: Amber