How to choose and track eCQMs

March 5, 2017

Written by Kristen Schuster, Practice Facilitator

For the CPC+ program, CMS will only take CQM data that is produced out of your EHR. That is what the “e” on eCQMs stands for. This means your CQMs must be set up and tracked in your EHR. You will NOT be able to use data that is manually chart abstracted or submitted through a registry, as you could in PQRS or can in MIPS.

First off, let’s discuss a little more about what eCQMs are before we dive in to the CPC+ requirements. Some of you may be familiar with them from other CMS quality reporting programs.

What are they? Electronic clinical quality measures (eCQMs) use data from an EHR to measure health care quality. They focus on processes, outcomes, observations, and treatments.

Why are they used? eCQMs are used to reimburse providers based on quality. More importantly, to have the EHR do the work instead of manually auditing charts. Time saver!

CPC+ eCQM Requirements:

Report a minimum of 9 possible eCQMs
- Appendix F: CPC+ eCQM 2017 in Payment Methodologies
- CMS advises to track more in the event of changes
Reporting period is January 1st,2017 to December 31st, 2017
eCQMs must be pulled for all eligible patients (not only Medicare Part B beneficiaries)
Review the eCQM library for measure definitions

How do you track them? If the practice has never ran reports for eCQM please reach out to your EHR vendor for assistance with setup. Otherwise, run baseline data for as many measures as the EHR allows. Choose measures that align with past quality improvement programs (PQRS, PCMH, MU, etc.) and ones that are close to or are reaching the CPC+ benchmarks.

To validate the eCQM data, identify issues by percentages that are abnormally low and begin to look at workflow and where the information is being captured in the EHR. The first step in eCQM quality improvement is always validating the data, and verifying all staff members are using the correct workflow and electronic data entry required for each measure.

Monitor the practice progress over time by designating a staff member to run monthly reports and compare against the CPC+ benchmarks.

If you need help with eCQM set up, workflow or eCQI (electronic clinical quality improvement), please let us know.

Don’t forget to network with practices through CPC+ Connect to share best practices and get ideas on eCQM work.

As always, complete CPC+ information from CMS can be found on the CPC+ Connect Portal. We encourage you to access the portal and check out all available CMS CPC+ resources.

If you have any questions, or run into issues with any of the CPC+ objectives and would like help please use the “Leave a Reply” section below, or email Kristen Schuster directly with your questions or comments.

Other Resource Links
CMS Change Package
Appendix F: CPC+ eCQM 2017 set
eCQI Resources
See all CPC+ Blog Posts

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