Oracle Health Simplifies eCQM Reporting

Quality reporting is becoming more and more common across multiple payers. During my time as Administrator of the Centers for Medicare and Medicaid Services (CMS), I sought to reduce the number of quality measures through an initiative called Meaningful Measures. It wasn’t that I didn’t believe in measuring quality, but I was deeply concerned about the additional burden it placed on providers. Instead, I approved only measures that could be calculated or generated through claims or other passive means that didn’t require providers to do extra work. I knew that one day our technology would catch up and we could increase quality reporting which is essential to value-based care and improving patient health outcomes and population health. Fortunately, we are at that point, and the Oracle Health Data Intelligence tool can help providers with quality reporting.?

For example, in today’s rapidly evolving healthcare landscape, Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) face increasing pressure to meet complex reporting requirements. Recognizing the burden put on ACOs, Oracle Health has launched new electronic clinical quality measures (eCQM) designed to simplify the process and enhance data accuracy. This latest release, a key component of Oracle Health Data Intelligence, can help alleviate many of the challenges ACOs face as they transition to the CMS new reporting method, the APM Performance Pathway (APP) . Oracle Health Data Intelligence can not only help with CMS measures, but potentially other quality metrics.

Addressing reporting challenges head-on

With this shift to APP reporting for 2025, ACOs will soon be required to report on a critical set of measures, such as diabetes, hypertension, and depression screening and intervention, for a broad population of both Medicare and non-Medicare patients. As ACOs prepare for this shift, Oracle Health’s new functionality supports both the Medicare CQM and APP eCQM collection types, giving ACOs the flexibility to choose the reporting method that best aligns with their objectives and helps optimize quality scores. Identifying patient care gaps in near real-time and early in the measurement year will support clinicians in driving optimal patient outcomes. The ability to track APP measure performance in 2024, while reporting is still voluntary, will help ACOs prepare for the beginning of 2025, when APP reporting becomes mandatory. These proactive insights will likely prove crucial for reporting on the chronic condition measure set where precision and compliance are vital.

Moving to eCQMs means ACOs must navigate new obstacles, including data aggregation, regulatory compliance, and interoperability between different EHRs. Oracle Health Data Intelligence directly addresses these hurdles to enable bringing accurate data capture across patient populations—offering ACOs the tools they need to track performance by providing actionable, EHR-agnostic workflow insights—and helping ACOs adjust to the evolving healthcare landscape.

Uniting data and driving insights

Oracle Health Data Intelligence turns data into actionable insights. It helps simplify regulatory compliance and provides health systems the agility to address changing requirements. Most importantly, it empowers them to engage patients, close care gaps, and find ways to reduce the cost of care delivery.

The system can integrate and continually update data from more than 3,000 sources, including clinical data from across EHRs, payer claims data, and public environmental and social data. Normalizing and standardizing these datasets into a patient-centric longitudinal record means Oracle Health Data Intelligence provides a comprehensive, near real-time view of patient outcomes clinicians can trust, helping health systems enhance both care delivery and financial performance. The suite is composed of these three solutions:

• Oracle Health Clinical Intelligence supports care quality, financial optimization, and regulatory compliance with population management solutions to proactively track performance against yearly quality goals and progress on CMS and commercial value-based care contracts. By harnessing longitudinal records, multi-program quality measures, and AI-powered analytics, intelligent insights and recommendations are available directly in cross-EHR workflows at the point of care.
• Oracle Health Care Coordination Intelligence enables care teams to coordinate proactive and prescriptive care, fostering patient engagement and supporting care gap closure. An ACO can continuously assess patients across the population to inform care delivery and coordination decisions in near real time, such as helping facilitate the right patients being enrolled in care management and prioritizing the patients with the greatest opportunity for improvements.
• Oracle Health Analytics Intelligence provides a robust data warehouse with pre-built analytics that track key metrics, offering insights to help drive efficiency and enhance patient care. An ACO can drill-in to detailed performance reports for each measure and compare across providers and explore cost and utilization improvement opportunities.

When used together, these solutions not only help simplify operational workflows but also work to help lower the total cost of care and improve population health.

Oracle Health is a CMS Qualified Registry in good standing and currently supports a wide array of value-based care content catalogs. These catalogs include ACO Web Interface, the Healthcare Effectiveness Data and Information Set (HEDIS), Clinical Standard, Merit-based Incentive Payment System (MIPS) CQMs, MIPS eCQMs via Oracle Health Millennium Platform, Eligible Hospital eCQMs, and Chart Abstracted measures. Customers using Health Data Intelligence are seeing, on average, 200M+ care gaps closed per year and a 40-60% increase in annual well visits year over year. Commercial customers also saw a 9-12% cost reduction per member per month over the last 36 months. The addition of APP reporting, with eCQM performance and submission, is designed to streamline reporting for ACOs. Considering the numerous value-based care arrangements ACOs are managing, Oracle Health Data Intelligence helps optimize regulatory reporting by helping enable performance tracking and submission for the multitude of content catalogs and reporting programs all within one, comprehensive solution.

Tools like Oracle Health Data Intelligence can go a long way in simplifying quality reporting and making it easier for providers to participate in value-based programs.

Learn More at NAACOS and Oracle Health Summit

Visit us this week at the NAACOS Fall Conference and at the Oracle Health Summit in Nashville, October 28-30, to explore how we can help your health system adapt, thrive, and deliver optimal patient outcomes. We will bring together thought leaders to discuss innovations and strategies for overcoming the industry’s biggest challenges. Oracle Health’s new eCQM functionality demonstrates a clear commitment to helping health systems and ACOs navigate an increasingly complex regulatory landscape, equipping them with the tools and flexibility needed to drive high quality care and operational success. Stay ahead of the curve with Oracle Health Data Intelligence .