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A federal policy and industry roadmap for trusted, scalable digital quality measurement for ACOs
Accountable Care Organizations (ACOs) are responsible for improving care and demonstrating value across populations that span multiple providers, practices, hospitals, electronic health record (EHR) systems, and care settings. Yet quality reporting remains heavily dependent on EHR-centered processes that can be labor-intensive, costly, difficult to scale, and disconnected from the infrastructure ACOs already use to manage population health.
This new report from Leavitt Partners Supporting Real-Time Quality Insights through HL7® FHIR® recommends that the Centers for Medicare & Medicaid Services (CMS) allow qualified ACOs to use standards-based HL7 Fast Healthcare Interoperability Resources (FHIR) infrastructure for Medicare quality reporting. While CMS recognizes this need and is moving towards this approach, regulatory changes described here are necessary to make this architecture possible without requiring it
Under this approach, EHRs would remain essential sources of clinical information, while ACOs could use population-level FHIR infrastructure to aggregate, validate, calculate, and report quality measures. The same infrastructure could also support care coordination, population health management, quality improvement, clinical decision support, and other authorized uses.