1. Regulations – July, 2017 Final 2018 MACRA regulations published
Awaiting final rule of the 2018 Inpatient Prospective Payment System
2018 Quality Payment Program Proposed Rule (comments – Aug 21, 2017)
2018 Physician Fee Schedule Proposed Rule (comments – Sept 11, 2017)
2018 Outpatient Prospective Payment System Proposed Rule (comments – Sept 11, 2017)

2. QPP Proposed Rule

3. QPP Proposed Rule

4. QPP Proposed Rule

5. Possible comment areas - QPP
Possible naming of FHIR-based standards in final rule
End-to-end electronic submission
Quality reporting submission mechanisms
The costs and benefits of using standards for reporting

6. Possible comment areas - QPP
QRDA III – possible new standards (FHIR)
“… we seek comment for future rulemaking regarding the potential shift to seeking alternatives which might fully replace the QRDA III format in the QPP in future program years….”
Comments:
HL7 strongly believes that the FHIR-based standards and resources developed for quality reporting have reach a level of maturity and readiness in the industry sufficient for CMS to consider naming and incorporating in the final QPP regulation the following elements:
FHIR Measure Report Resource: which defines the report itself, and since it is based on QRDA, it is fully aligned with it.
QI Core Profile: on top of the FHIR Measure Report Resource to capture and represent quality information, and as based on the US Core profile to define measure content
Established a transition period of 12 months during which both the current QRDA III and these two FHIR- based profiles/resources will be acceptable for use. It will be important to ensure that if both sets of standards are allowed to be used during a transition period, that both sets of standards produce the exact same results for the same measures. This should be mitigated by the fact that QI Core maps to QDM-based HQMF standard
Leave the measure on HQMF and CQL and allow reporting using these two FHIR-based standards, in addition to QRDA III
By naming these two elements in the final QPP regulation, CMS will provide the industry with a roadmap for the future of quality reporting standards. This will also help fast-track the final refinement, adoption and use of these standards

7. Possible comment areas - QPP
End-to-end electronic submission
Quality reporting submission mechanisms
The costs and benefits of using standards for reporting