Health Care Efficiency Through Flexibility Act
Sponsored By: Representative Buchanan
In Committee
Summary
Expand and standardize quality reporting for Accountable Care Organizations in the Medicare Shared Savings Program. It would require multiple reporting collection types for measures in 2025–2029 and establish a digital quality-measure pilot for 2028–2032.
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- ACOs: Would need to make three collection types available for each required measure in 2025–2029: electronic clinical quality measures, MIPS (Merit-based Incentive Payment System) clinical quality measures, and Medicare Clinical Quality Measures for ACOs.
- ACO participants and providers: For measures starting in 2025 or later, data can be excluded from completeness checks if an ACO shows a participant could not collect it using the selected collection type and the remaining data meet completeness rules.
- Digital pilot and CMS duties: Would run from 2028–2032 and require selected ACOs to submit two digitally specified measures per year, allow waivers of other measures that year, and provide technical assistance. The Secretary would publish an analysis, recommendations to increase digital submissions, and a proposed timeline by December 31, 2032.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
More flexible reporting for Medicare ACOs
If enacted, Medicare Accountable Care Organizations (ACOs) would get more ways to report required quality measures. For performance years 2025 through 2029, the Secretary would make three collection types available for each measure: electronic clinical quality measures, MIPS clinical quality measures, and Medicare ACO clinical quality measures. Starting with performance year 2025, ACO data could not be labeled unrepresentative just because data from one or more ACO participants is missing, if the submission meets federal data completeness rules and the ACO shows those participants could not collect data using the chosen method.
Digital reporting pilot for Medicare ACOs
If enacted, CMS would run a digital quality reporting pilot for Medicare ACOs in performance years 2028 through 2032. Selected ACOs that apply would report two measures each year using a digital method set by the Secretary. The Secretary could waive other required measures for those ACOs that year. CMS would ignore the pilot data and any waived measures when judging whether ACOs met quality standards or in quality scores for that year. CMS would provide technical help and post results, recommendations, and a proposed timeline by December 31, 2032.
Sponsors & CoSponsors
Sponsor
Buchanan
FL • R
Cosponsors
Panetta
CA • D
Sponsored 9/15/2025
Crenshaw
TX • R
Sponsored 9/15/2025
LaHood
IL • R
Sponsored 9/15/2025
Lawler
NY • R
Sponsored 1/12/2026
Roll Call Votes
No roll call votes available for this bill.
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