WASHINGTON, D.C. — The U.S. House of Representatives passed H.R. 5347, the Health Care Efficiency Through Flexibility Act, on Monday by a voice vote. The legislation allows Medicare accountable care organizations (ACOs) within the Medicare Shared Savings Program to use various quality data collection methods through performance year 2029.

Under the act, ACOs can collect quality data through electronic clinical quality measures (eCQMs), Merit-Based Incentive Payment System clinical quality measures, and Medicare clinical quality measures. This provision modifies a 2024 Centers for Medicare & Medicaid Services (CMS) regulation that had required ACOs to exclusively use eCQMs starting in 2024.

H.R. 5347 mandates that CMS establish a pilot program to test other digital reporting methods for ACOs from 2028 to 2032. ACOs participating in this pilot would be exempt from using other reporting methods during that period. Upon conclusion of the pilot program, CMS would be required to publicly analyze the results and provide any related recommendations.

Rep. Vern Buchanan (R-Fla.), chairman of the House Ways and Means Health Subcommittee, said in a statement, "By ensuring ACOs have access to multiple quality reporting pathways, my bipartisan legislation will reduce excess regulatory burden on ACOs and allow providers to focus on delivering high-quality, value-based care." He added, "I look forward to my bill being considered by my Senate colleagues and ensuring that it is signed into law to improve care, lower costs, and make life easier for patients and doctors alike."

Rep. Jason Smith (R-Mo.), chairman of the Ways and Means Committee, said in a statement, "Medical providers, including those participating in accountable care organizations, should not be distracted from providing better healthcare at a lower cost by uncertain Washington reporting rules." Smith also stated, "The Health Care Efficiency Through Flexibility Act puts patient care first by giving medical providers the stability and flexibility to report quality measures the way that suits them best and ensure a smooth transition to digital reporting methods." He added, "This policy is particularly helpful for small, rural, and independent physician practices who often lack the sophisticated software needed to comply with the digital reporting regime but are successful value-based care providers."

America's Physician Groups, which represents more than 300 physician member organizations, supports H.R. 5347. Susan Dentzer, president and CEO of the group, said in a podcast interview, "We are very happy about the House passage of the H.R. 5347, as we have been advocating enthusiastically for its passage for some months." Dentzer added, "We believe that measuring quality in healthcare and reporting on appropriate quality measures is vital to the success of value-based care, in which all our more than 300 physician member organizations are engaged." She continued, "And we do believe that -- beyond the vitally important question of which quality measures should be collected -- the future surely lies in doing so through electronic or digital quality measures." However, Dentzer noted, "the state of play now for many Medicare Shared Savings Plan ACOs -- in which many of our members participate -- is that much of the healthcare system isn't yet ready to report quality data to CMS using electronic clinical quality measures." She explained, "The data needed to support these measures must be collected and reported right out of electronic health records, and not all [electronic health record] systems are currently configured to collect the specified measure data appropriately." Dentzer concluded, "It's just a matter of common sense to give ACOs temporary flexibility (through performance year 2029) to choose one of three appropriate channels for reporting quality data while all Medicare Shared Savings Plan ACOs work toward the eventual goal of full implementation of eCQMs." Regarding the pilot program, she said, "In principle, we are fully supportive of the long-term push toward eCQMs, but it will be very helpful to test the approach broadly to surface any other issues that must be addressed before all ACOs use them as the sole quality reporting mechanism."

H.R. 5347 has co-sponsors including Reps. Dan Crenshaw of Texas, Darin LaHood of Illinois, Mike Lawler of New York, and Jimmy Panetta of California. The National Association of Accountable Care Organizations, America's Physician Groups, Accountable for Health, and the Healthcare Information and Management Systems Society have indicated support for the bill. There is no companion measure for H.R. 5347 in the Senate at this time.