Electronic Clinical Quality Measures (eCQMs) on Healthie

As part of its ONC Certification, Healthie can capture, export, calculate and report on measured meaningful use data through Clinical Quality Measures (eCQMs). 

eCQMs are used by the Centers for Medicare & Medicaid Services (CMS) in a variety of quality reporting and value-based purchasing programs.

Note: This feature is available on our Production (not Staging) Environment.

Fees

Organizations wishing to utilize Healthie’s clinical quality measures will incur both annual and one-time fees depending on the needs of the organization.  

If your organization is interested in learning more about measuring eCQMs, and meaningful use reporting, through the Healthie platform, please email hello@gethealthie.com to get started. 

Implementation

Reach out to hello@gethealthie.com to get started with eCQMs for your practice.

Please include this information in your request:

• Practice name
• Org NPI
• Provider(s) Name/NPI/email
• If reporting will be at individual or group level (or both)

Timeline

The timeline for setup and implementation will vary depending on your organization's needs, and the specific eCQMs you’re looking to measure. The process can take up to 6 months. 

eCQMs Available in Healthie

The following eCQMs are available within Healthie:

CMS2v14: Preventive Care and Screening: Screening for Depression and Follow Up Plan

CMS22v12: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

CMS68v13: Documentation of Current Medications in the Medical Record

CMS69v12: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

CMS951v3: Kidney Health Evaluation

CMS122v12: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)

CMS125v12: Breast Cancer Screening

CMS130v12: Colorectal Cancer Screening

Using eCQMs

Eligible clinicians report quality measures to The Centers for Medicare & Medicaid Services, or other federal health agencies, and to commercial insurance payers in programs that track and/or reimburse based on quality reporting or quality performance.

Once your practice has been enabled with quality measures, you will see the measures that you requested included as charting forms in your Forms section in Healthie. These forms will have the standard title for each measure such as:

• Kidney Health Evaluation
• Body Mass Index (BMI) Screening and Follow-Up Plan

When these forms are added to your Healthie account, they are ready to use.

FAQs

What are eCQMs?

Electronic clinical quality measures (eCQMs) are measures specified in a standard electronic format that use data electronically extracted from electronic health records (EHR) and/or health information technology (IT) systems to measure the quality of health care provided. 

How do eCQMS differ from older clinical quality measures?

eCQMs differ from older clinical quality measures because they rely on structured (formally coded) data fields analyzed by computers rather than expert abstraction from paper charts, or a combination of structured and free-text fields of an EHR. They convert information about care processes or outcomes into a rate or percentage that allows providers, facilities, and patients to measure and evaluate aspects of care. Once eCQMs have been integrated into a health IT system, they can run in the background, seamlessly measuring practice results.

Learn more here.

Why would I want to utilize eCQMs?

Measuring and reporting eCQMs helps to ensure that our healthcare system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. CMS’ eCQMs measure many aspects of patient care, including but not limited to:

• Patient and Family Engagement
• Patient Safety
• Care Coordination
• Population/Public Health
• Efficient Use of Healthcare Resources
• Clinical Process/Effectiveness

Can I bill for Medicare and Medicaid if I don’t report on clinical quality measures?

Yes, you can still bill Medicare and Medicaid without the use of eCQMs, however, it will be done at a penalized rate.

Where can I find a list of all eligible clinician eCQMS?

You can find a list of eligible clinician eCQMs on the HealthIT.gov website here.  

What eCQMs are right for my organization?

There is no one standard group of eCQMs to report on; every organization will need to determine the measures that are most applicable to the type of service they provide.

Who needs to report on eCQMs?

By 2025, Accountable Care Organizations will need to analyze 100% and report on 70% of all patients who meet the measuring criteria, regardless of payer.

How are eCQMs and MIPS (Merit-based Incentive Program) different?

The difference between eCQMs and MIPS CQMs comes down to the source of the data. Healthie does not currently support MIPS reporting.

If you are interested in utilizing the MIPS reporting structure, please submit a new idea for our team to review so that we can add it to our roadmap. Learn how to do so here.

You'll find our current roadmap on our Product Portal.

What happens if I don’t complete MIPS?

Unless you qualify for an exemption from MIPS in 2023, you will receive a -9% payment adjustment to your Medicare Part B fee-for-service (FFS) claims in 2025.

How many eCQMs does my organization need to report on?

What is required for reporting can vary depending on what entity is being reported to. For Medicare and MIPS, eligible clinicians report on 6 quality measures. But eCQMs are just one type of quality measure that could be reported on, so the practice should decide how many and which measures they should plan to report on. That could be 6 eCQMs, or it could be fewer eCQMs plus other types of quality measures.

Here is an informative link for Medicare and MIPS: https://qpp.cms.gov/mips/quality-requirements

To participate in MIPS (Merit-Based Incentive Payment System) for Medicare

Eligible Clinicians must collect and submit measure data for the 12-month performance period (e.g. January 1 - December 31, 2026).

There are 5 collection types for MIPS quality measures:

• Electronic Clinical Quality Measures (eCQMs);
• MIPS Clinical Quality Measures (CQMs);
• Qualified Clinical Data Registry (QCDR) Measures;
• Medicare Part B Claims Measures;
• Administrative Claim

General reporting requirements are as follows:

• You’ll need to submit collected data for at least 6 quality measures (including one outcome measure or high priority measure in the absence of an applicable outcome measure), or a complete specialty measure set.
• For the 2025 performance period, you’ll need to report performance data for at least 75% of the denominator-eligible cases for each quality measure (data completeness), which will continue through the 2028 performance period.
• You can submit measures from different collection types to fulfill the requirement to report data for at least 6 quality measures.

What is a performance period for eCQMs?

The performance period for reporting eCQMs is one calendar year, e.g. January 1, 2026  - December 31, 2026.

What is data completeness?

For the 2025 performance period, you’ll need to report performance data for at least 75% of the denominator-eligible cases for each quality measure (data completeness).

Data completeness refers to the volume of performance data reported for a quality measure’s eligible population. Data completeness only applies to the quality performance category.

• Your submission must identify the total eligible population/denominator for the 12-month performance period as outlined in the measure’s specification.
• You must report performance data (performance met or not met, or denominator exceptions) for at least 75% of the total eligible population/denominator.

Example.

There are 200 patients that meet the criteria for a measure’s eligible population. When you report the measure, your submission needs to identify the eligible population as 200 patients and report performance data for at least 150 patients (150 is 75% of 200) that are representative of your performance.

• Meets data completeness: Performance Met (100) + Performance Not Met (30) + Denominator Exceptions (30)
  • Performance data reported for 160 (out of 200) patients – 80%
• Doesn’t meet data completeness: Performance Met (100) + Performance Not Met (20) + Denominator Exceptions (20)
  • Performance data reported for 140 (out of 200) patients – 70%