December 21, 2012
The federal Centers for Medicare and Medicaid Services released ACO quality measures benchmarks in “Accountable Care Organization 2013 Program Analysis; Quality Performance Standards Narrative Measure Specifications.” The ACO quality measuresbenchmarks are to be reported through a combination of CMS claims and administrative data, the ACO Group Practice Reporting Option web interface for clinical measure reporting, and patient experience of care surveys. For pay for performance measures, the minimum attainment level will be set at a national 30% or the national 30th percentile of the performance benchmark. Performance benchmarks will be national and established using national fee-for-service (FFS) claims data, national Medicare Advantage quality reporting rates, or a flat national percentage for measures where Medicare Advantage or FFS claims data is not available. Performance equal to or greater than the minimum attainment level will receive points on a sliding scale based on level of performance. Performance at or above 90% or the 90th percentile of the performance benchmark will earn the maximum points for the measures.