H.R. 5347 — Health Care Efficiency Through Flexibility Act

This section requires the Secretary, for performance years 2025 through 2029 under the Medicare Shared Savings Program (MSSP), to ensure availability of three specified collection types—(I) electronic clinical quality measures, (II) MIPS clinical quality measures, and (III) Medicare Clinical Quality Measures for Accountable Care Organizations—for each required quality measure reported by an ACO. (The MSSP enables groups of providers, known as ACOs, to manage and coordinate care for assigned Medicare fee-for-service beneficiaries and share in cost savings if they meet specified quality standards.) It further clarifies that, for performance years beginning on or after January 1, 2025, the Secretary may not deem an ACO's data unrepresentative for data completeness purposes solely due to excluded data from one or more ACO participants if the submitted data otherwise complies with requirements and the ACO demonstrates those participants' inability to collect the data via the selected collection type.

This section establishes a pilot program for digital quality measure reporting under the Medicare Shared Savings Program (i.e., the shared savings program for accountable care organizations (ACOs) that coordinate care for Medicare fee-for-service beneficiaries) for performance years 2028 through 2032. Under the pilot program, the Secretary (1) selects participating ACOs based on applications; (2) specifies two quality measures otherwise required to be reported by ACOs that selected ACOs must report via a Secretary-specified digital collection type; (3) waives requirements for selected ACOs to report any other quality measures; (4) disregards data from the specified measures or non-reported measures when determining whether selected ACOs meet quality performance standards or in calculating quality scores for ACO participants; (5) provides technical assistance to selected ACOs; and (6) by December 31, 2032, publicly posts an analysis of the program, recommendations for increasing digital submissions of quality measures, and a proposed timeline for requiring such measures via digital collection.