On November 17, 2016, CMS released three application program interfaces (APIs) that make it easier to analyze the Medicare Access and CHIP Reauthorization Act of 2015 Quality Payment Program (QPP) measures and to build software applications that use the measures. The APIs include lists for the QPP performance measures categories: (1) a list of all Quality measures, (2) a list of Advancing Care Information measures, and (3) a list of Clinical Practice Improvement Activities. Each API makes it possible to electronically retrieve the information in the lists in an automatic and structured manner and to incorporate the information into software applications to help clinicians track their performance in the QPP. The release of the APIs will facilitate the use of QPP measures in software developed by or for clinicians. CMS posted the APIs on the QPP website.
MACRA replaced the sustainable growth rate updates to the Medicare Physician Fee Schedule with the QPP. The QPP adjusts clinician payments for performance under one of two tracks: Advanced Alternative Payment Models (APMs) and the Merit-based Incentive Payment System (MIPS). Participation in an APM allows clinicians to earn incentive payments for participating in an innovative payment model. Participation in the MIPS allows physicians to earn a performance-based payment adjustment. Under both tracks, participants report certain measures to CMS. CMS’s website currently lists a total of 271 measures, leaving it to clinicians to select measures that best fit each practice. CMS’s APIs will facilitate the development of software to select measures, keep track of performance, and report measures to CMS.
The APIs released by CMS contain the measures in all three of the 2017 MIPS measure categories: Quality, Clinical Practice Improvement Activities, and Advancing Care Information – formerly the EHR Meaningful Use program. (A fourth category, Costs, will not be used for payment adjustments in the first reporting year and is based on data reported through claims.) These measures may also be reported in some cases in the APM track. The API for Quality measures returns the list of all measures in the Quality category. The results include the identifier numbers for measures in the CMS, National Quality Forum, and Quality indices. The API for Advancing Care Information measures returns the list of measures in this category, including whether a measure contributes to the performance score as an optional bonus. The API for Clinical Practice Improvement Activities returns the entire list of the Improvement Activities, allowing users to group the results and weigh each activity.
