Health Care Efficiency Through Flexibility Act
Health Care Efficiency Through Flexibility Act would pause the transition from the current CMS Web Interface quality reporting to electronic Clinical Quality Metrics (eCQMs) for Accountable Care Organizations (ACOs) and their participants, delaying the mandatory eCQM reporting until January 1, 2030. The bill creates a parallel path: a pilot program (by January 1, 2026) to test digital reporting methods for quality measures on a subset of ACOs that opt in, with temporary exemption from eCQM requirements during the pilot and no change to payment incentives. The Secretary of Health and Human Services would develop long-term digital quality reporting standards by January 1, 2030, in consultation with stakeholders, while allowing continued use of existing reporting methods (CMS Web Interface, MIPS/CQMs, eCQMs, etc.) until the new standards are in place. The bill also requires a congressionally delivered report by January 1, 2028 on the pilot’s findings and recommendations. Penalties for not meeting eCQM requirements would not apply before 2030 if a provider remains compliant with existing methods.
Key Points
- 1Delays the mandatory shift to eCQM reporting for ACOs until January 1, 2030, maintaining current reporting methods in the meantime.
- 2Establishes a pilot program (by January 1, 2026) to test digital reporting methods for quality measures with a subset of ACOs; participants are temporarily exempt from mandatory eCQM reporting during the pilot.
- 3Participation in the pilot does not affect eligibility for or receipt of incentive payments or payment adjustments under Medicare quality programs.
- 4Secretary must provide technical assistance and waivers to pilot participants to encourage participation and evaluate digital reporting methods; a Congress-facing report with findings is due by January 1, 2028.
- 5By January 1, 2030, the Secretary must implement long-term digital quality reporting standards, ensuring compatibility with diverse EHR systems and practice settings, after broad stakeholder consultation (including NCQA, EHR vendors, ACOs, payers, and medical groups).
- 6Before standards are finalized, ACOs may continue using CMS Web Interface, MIPS CQMs, Medicare CQMs, eCQMs, or other existing methods; penalties for non-compliance with eCQM requirements are waived if they follow existing methods.