Demystifying eCQM Data Submission: A Strategic Guide for ACOs and Health Plans
As value-based care continues to reshape the healthcare landscape, electronic Clinical Quality Measures (eCQMs) have emerged as a cornerstone for measuring performance and improving patient outcomes. For Accountable Care Organizations (ACOs), health plans, and provider groups, submitting eCQM data is no longer just a regulatory requirement—it’s a strategic opportunity.
At Hexplora, we empower organizations across the care continuum to seamlessly capture, aggregate, and submit eCQM data, driving shared savings and quality improvements. In this blog, we break down the process, challenges, and how the right partner can make all the difference.
What are eCQMs?
eCQMs are standardized metrics that assess how well healthcare providers deliver care based on clinical data extracted directly from electronic health records (EHRs). They cover key domains such as:
- Preventive care (e.g., colorectal cancer screening)
- Chronic condition management (e.g., diabetes control)
- Behavioral health
- Patient safety and engagement
These measures help track performance on quality initiatives across Medicare Shared Savings Program (MSSP), Medicaid programs, and commercial value-based contracts.
Who Needs to Submit eCQMs?
CMS requires participating ACOs under the MSSP to submit 3 eCQMs or MIPS CQMs beginning with Performance Year 2025, using the APP (Alternative Payment Model Performance Pathway) framework.
Submission is all-payer and patient-level, meaning ACOs must report on their entire population—not just Medicare FFS—regardless of payer, race, or language.
Key Components of eCQM Data Submission
- Data Aggregation from Multiple EHRs
- Most ACOs work with providers using different EHRs.
- Hexplora’s platform connects to all major EHR vendors and aggregates multi-source clinical data.
- We normalize and standardize data to FHIR/QRDA formats as required by CMS.
- Measure Computation
- We run a certified CQL engine to compute eCQMs accurately.
- Our platform supports a wide range of measures—HEDIS, Medicaid, Medicare—and aligns them with custom client needs.
- Data Quality & Validation
- Before submission, we run automated data validation rules and provide drill-down capabilities to pinpoint issues at the provider, site, or patient level.
- Submission to CMS
- We support QRDA I and III formats.
- With our secure cloud infrastructure on Microsoft Azure, we automate packaging and transmission of patient-level data for submission via the CMS portal or APIs.
- Real-Time Dashboards & Feedback
- Clients get interactive dashboards showing measure performance in real-time.
- Insights drive quality improvement before the submission window closes.
Common Challenges in eCQM Submission
- Data fragmentation across multiple EHRs
- Inconsistent documentation and coding
- Resource constraints in IT and quality teams
- Understanding measure specifications and mapping clinical workflows
Hexplora solves these with:
- Seamless EHR integrations
- Pre-built connectors and FHIR support
- A user-friendly analytics platform
- Expert support for measure interpretation and data remediation
Why Hexplora?
- Certified Measure Vendor: We meet the highest standards for data accuracy and regulatory compliance.
- Fast Implementation: Deploy in as little as 2 weeks.
- Trusted by ACOs, Health Plans, and IPAs: Our clients have improved both their quality scores and bottom line.
- Unmatched Customer Support: We guide you through every step—from onboarding to final submission.
Final Thoughts
eCQM submission isn’t just about compliance—it’s about visibility, accountability, and transformation. By investing in a robust data infrastructure and partnering with an experienced analytics provider like Hexplora, organizations can not only meet CMS requirements but also unlock insights that improve care quality and reduce costs.
Want to learn how Hexplora can help your organization succeed with eCQMs? Request a Demo
