Health Care Efficiency Through Flexibility Act

This bill changes how Accountable Care Organizations (ACOs) in Medicare’s Shared Savings Program report quality data. From 2025 through 2029, Medicare must offer three ways to send in these measures: electronic clinical quality measures, MIPS clinical quality measures, and Medicare ACO quality measures.

It also says that if an ACO meets the data rules but can’t include data from one or more of its participants because those participants couldn’t use the chosen collection method, Medicare can’t mark the ACO’s data as “unrepresentative” just for that reason, starting in 2025.

The bill creates a test program from 2028 to 2032 to try fully digital reporting. Selected ACOs will report only two specified measures through a digital method each year. Data submitted under this pilot will not count toward an ACO’s quality score or toward the MIPS quality scores of its participants. Medicare will offer technical help and publish an analysis, recommendations, and a proposed timeline for broader digital reporting by December 31, 2032.

Key points

• Who is affected: ACOs in Medicare’s Shared Savings Program and their participants; Medicare oversight agencies; patients indirectly through quality reporting changes.
• What changes: More reporting options in 2025–2029; flexibility when some participants can’t collect data via the chosen method; a 2028–2032 digital reporting pilot that doesn’t affect quality scores .
• When: Options and flexibility begin in 2025; the digital pilot runs 2028–2032; a public report is due by December 31, 2032 .