Roji Intel Blog

Theresa Hush 0
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APP Reporting, APP Measures, health care cost savings
ACOsAPP ReportingData Best PracticesValue-Based Health Care
March 4, 2024

3 Ways Your ACO Can Convert APP Reporting Data into Higher Savings

Controlling costs is a key Value-Based Care goal, a fact well-known to ACOs that share savings with CMS. Even as individual ACOs have generated tens of millions of dollars in savings, however, MSSP ACOs as a whole have only been able to reduce their Total Cost of Care (TCOC) by a fraction. That is a program vulnerability and one reason why value-based payments are increasingly incorporating population-based payment. Plainly stated, claims data (especially 2-5 months old) isn’t a great tool for identifying patient risks, Medicare HCCs notwithstanding. The timeline for cost prevention is before events occur, not when you’re looking…
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Theresa Hush 0
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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.
ACOsAPP ReportingData AggregationValue-Based Health Care
January 11, 2024

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

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…
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Roji Health Intelligence 0
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ACOsAPP ReportingCMS RulesMedicareValue-Based Health Care
December 12, 2023

How Your ACO Can Optimize APP Reporting Using Medicare CQMs

ACOs just gained a reprieve from implementing all-patient APP quality reporting in 2024. A provision in CMS’s Physician Fee Schedule Final Rule, which goes into effect on January 1, 2024, enables ACOs to report on Medicare patients only, based on CMS provision of eligible patient lists for three APP measures. If your ACO decides to delay aggregation of practice data for now, you need to consider how to optimize APP Reporting of Medicare CQMs. Choose a qualified registry for APP Reporting that can reduce your workload for reporting Medicare CQM Measures. Using CMS’s list of patients eligible for measures will…
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Theresa Hush 1
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Roji Health Intelligence Three Tips APP Reporting Approach ACOs Value-Based Care
ACOsAPP ReportingData AggregationValue-Based Health Care
August 11, 2023

Three Tips for Choosing Your APP Reporting Approach

If CMS’s new proposed option for APP Reporting becomes part of the Final Rule, ACOs will have the ability to limit quality reporting to Medicare patients only. Your ACO must now determine whether reporting Medicare-only patients saves work and money and best demonstrates your quality. Use these Roji TIPS to decide what approach will work for you. Considerations for Choosing Medicare CQMs versus All-Patient Reporting ACOs have resisted APP Reporting to avoid data aggregation from different physician EHRs. ACOs also want to limit their work to the core of Medicare patients included in the ACO. The following considerations are key…
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Theresa Hush 0
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Roji TIPS APP Reporting data aggregation ACOs
ACOsAPP ReportingData Best PracticesValue-Based Health Care
July 27, 2023

New for ACOs: Roji TIPS for Implementing APP Reporting

With the advent of APP Reporting, ACOs face a fundamental change in not only how they report quality measures, but also how they use data to drive results. That's true whether APP Reporting involves reporting quality for all patients or for Medicare-only patients via Medicare CQMs. Data is an asset that ACOs have never had. But data has the potential to influence all ACO functions and its success. Rather than depending on past admissions and ER utilization to retrospectively contact patients, ACOs that initially aggregate data will be able to use it to proactively identify patients who need more specific…
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Dave Halpert 0
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APM Performance PathwayAPP ReportingCMS RulesData Best PracticesMIPS Value PathwaysValue-Based Health Care
July 19, 2023

The 2024 CMS PFS Proposed Rule: 7 Attempts to Balance Participation Goals with Value

Reading between the many lines in the 1,920-page 2024 Medicare Physician Fee Schedule (PFS) Proposed Rule, one thing is clear: CMS is still struggling to move providers into Advanced Alternate Payment Models (APMs) and keep existing ACOs moving forward on the path to value-based payments. The APP Reporting tug-of-war between CMS and ACOs results in a slight concession for providers worried about difficulty and cost of all-patient APP Reporting. We’ve seen this before, of course. Remember the delay in sunsetting the Web Interface for ACOs in the 2022 Rule and the retreat from mandatory transition to risk in the 2023…
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Theresa Hush 1
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ACOsAPP ReportingData Best PracticesValue-Based Health Care
June 16, 2023

Don’t Fall for Magical Thinking in APP Reporting

Since the adoption of the 2023 Final Rule requiring ACOs to adopt Alternate Payment Model Performance Pathway (APP) quality reporting by performance year 2025, many ACOs have been scrambling to understand how to make the leap. There’s a huge difference between the old method of quality reporting using the CMS Interface to report on a 248-patient sample and the new requirement for APP reporting on all practice patients, regardless of payer type. The sheer size of reporting volume and mechanics means that your ACO will need to aggregate practice EHR data for the first time, even with fewer measures under…
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Theresa Hush 1
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ACOsAPP ReportingQuality Payment ProgramValue-Based Health Care
March 2, 2023

Amplify Your APP Payoff: Boost Quality and Costs with 3 Essential Data Types

Many ACOs are in the throes of planning to adopt APP Reporting. It’s a massive undertaking that can be costly, depending on your ACO's configuration of practices. If your ACO is scrambling to sort this out, you’re not alone in your abrupt initiation into the world of EHR data. Welcome to the joy ride. In our last post, we explained how to maximize the value of data aggregated for quality, as produced by either the HL7 and flat file method, or the QRDA method. Here we break down the data you need to achieve better quality in terms of patient…
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Theresa Hush 1
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Roji Health Intelligence ACO Data APP Reporting
ACOsAPP ReportingValue-Based Health Care
February 2, 2023

Three Lies and a Truth About ACO Data for APP Reporting

If you're an ACO worried about APP Reporting, we get it. Your concerns about the feasibility and costs of aggregating data from multiple systems are completely valid. But don't let data complexity hoodwink you into a simplistic solution that will cost you more than the data is worth. Your solution to data aggregation needs to focus on "value," which means that your data aggregation should also garner the most return for your investment. If you are a one-EHR type of ACO, your data aggregation is relatively straightforward, and the cost will be reasonable. But you’re facing very different challenges if…
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Theresa Hush 0
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ACO ReportingAPP ReportingCMS RulesValue-Based Health Care
January 5, 2023

Prepare Your ACO for APP Reporting with Our Ultimate Guide

No way out. That's the message of the CMS 2023 Final Payment Rule regarding APP quality reporting for ACOs. ACOs hoping for a reprieve to avoid all-patient quality reporting did not get it. APP Reporting will go forward by 2025, and ACOs must aggregate the patient data from provider systems to enable it. CMS has made it clear that accountable health care requires all-patient data to support both quality and equity in patient health care. You will need to act quickly. It takes experience, technology, and time to create the framework for a multi-practice database. You will need to become…
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