If you work in healthcare, you need to understand eCQMs. These electronic clinical quality measures are changing how doctors and hospitals report quality data. Let us explain what eCQMs are and how they compare to other reporting options.
What eCQMs Actually Mean?
The term eCQMs stands for electronic clinical quality measures. Your EHR system pulls patient data automatically and uses it to show how well you are treating patients. There is no manual chart review needed.
For example, an eCQM might track whether your diabetic patients got their blood sugar tests on time. Or it checks if heart patients received the right medications. The system grabs this information straight from your electronic records.
How eCQMs Pull Data?
Your EHR collects patient information every day as you see patients. When reporting time comes, eCQMs look at specific data points. The system searches for diagnosis codes, lab results, prescribed drugs, and procedures you performed.
This data gets organized into a file called QRDA III or JSON format. You submit this file to CMS electronically. The system then calculates your quality scores without anyone counting things by hand.
One big advantage is that eCQMs capture every patient automatically. If a patient did not get a service, the system knows that too. This means you hit 100% data completeness without extra work.
MIPS CQMs Work Differently
MIPS CQMs are MIPS quality measures you report through registries. You are not always pulling everything from your EHR. Sometimes registries use claims data or someone manually enters information.
With MIPS CQMs, you need to document when something happened AND when it did not happen. This helps you meet the 75% data completeness rule for 2025. If you see 100 patients for a measure, you must have documented results for at least 75 of them.
But MIPS CQMs are going away soon. CMS said they will only be available through 2026 for most providers. After that, you need to switch to eCQMs or find another option.
Medicare CQMs Are Just for ACOs
Medicare CQMs were created only for Medicare Shared Savings Program (ACOs). They work like MIPS CQMs but focus on just Medicare Part B patients, not your entire patient group.
This smaller patient pool sounds easier. But Medicare CQMs do not let you use the special scoring bonuses that eCQMs offer. You must hit tougher benchmark scores across all your measures.
CMS sends ACOs lists of eligible Medicare patients every quarter. But the timing can be tight. The fourth quarter list might arrive in February, giving you just one month before the March deadline.
Comparing the Three Types
With eCQMs and MIPS CQMs, you report on all patients, no matter what insurance they have. Medicare, Medicaid, private insurance, and uninsured patients all count. Medicare CQMs only look at Medicare fee for service patients.
Let’s break down the differences that affect your daily work.
Data Collection Work
eCQMs handle most work automatically through your EHR. MIPS CQMs and Medicare CQMs often need more manual tracking to reach that 75% data completeness target.
How You Submit
All three types use electronic submission. eCQMs can use QRDA III or JSON files. MIPS CQMs and Medicare CQMs require JSON only.
Scoring Advantages
This is where eCQMs really help. If you are an ACO using eCQMs through the Alternative Payment Model Performance Pathway, you can get maximum shared savings by meeting just two benchmarks. You need the 10th percentile on one outcome measure and the 40th percentile on one other measure.
Compare that to Medicare CQMs where you must hit 40th percentile scores across ALL measures. The difference is huge.
Starting in 2025, organizations using eCQMs also get bonus points through the Complex Organization Adjustment. Each submitted eCQM that meets data completeness requirements earns an extra achievement point.
Picking the Right Option
So which type should you pick? It depends on your current situation.
Go with eCQMs if:
- Your EHR system can create the required files
- You can pull data from your whole organization
- You want the best scoring advantages
- You are ready to invest in the future
Pick Medicare CQMs if:
- Your EHR cannot make QRDA files yet
- You need time to set up all payer data collection
- You mainly focus on Medicare patients
- You want a temporary bridge solution
Use MIPS CQMs if:
- You work with a registry that is not ready for eCQMs yet
- You need flexibility in how you collect data
- You understand they are being phased out by 2026
Problems You Will Face
Getting Data from Multiple Systems
If you have several practices with different EHR systems, combining data gets messy. You need a way to match patients across systems without creating duplicates.
Working with a MIPS reporting company, that can help. They specialize in pulling together data from multiple sources.
Hitting Data Completeness Goals
Many practices think they document everything but find gaps when they start measuring. The fix is adding reminders in your EHR so providers know what needs to be documented.
Tracking All Patients Not Just Medicare
When you are used to focusing on Medicare patients, tracking everyone feels like too much. The trick is treating quality improvement as something you do for all patients, not just one insurance group.
What Comes Next?
CMS is being very clear about where this goes. Everything points to everyone using eCQMs eventually. The APP Plus quality measure set keeps growing. By 2028, it will include eleven measures from the Adult Universal Foundation.
By 2027, many registry based reporting options will not work for ACOs anymore. That is not far away when you think about how long it takes to change systems in MIPS healthcare.
Getting Started with eCQMs
If you are ready to start, first test if your EHR can make QRDA files. Run test reports and compare them to manual chart reviews. Look for any gaps in how your clinical data gets captured.
Work on getting all your providers to document things the same way. When ten doctors document blood pressure control ten different ways, your eCQMs will not capture everything right.
Think about working with experts who do this every day. Prime Well Med Solutions is help practices move to electronic quality measurement without messing up patient care.
Why This Matters?
eCQMs are where healthcare quality measurement is headed. They give you better scoring chances, less manual work once set up, and they match future CMS requirements. MIPS CQMs and Medicare CQMs still exist but they are clearly temporary options.
Moving to eCQMs takes investment in technology and changing how you work. But organizations that do this now will be ready for value based care programs, MIPS reporting needs, and the bigger focus on clinical quality measures across all patients.
Understanding these differences helps you make smarter choices for your practice and your patients. Quality measurement is going digital, and eCQMs are leading that change.
May You Need to Read:
5 MIPS Confusing Parts That Trip Up Healthcare Providers And How to Fix Them
Understanding the Final Rule for MIPS: What Healthcare Providers Need to Know
Proactive vs Reactive: How Your Reporting Mindset Affects MIPS Performance
