AMP Newsletter: April updates and deadlines for health plans and providers: 2023 MY Atlas results are live, new CDII quality report cards are coming soon, and IHA is headed to the APG annual conference
Self-reporting provider organization review period
Self-reporting provider organizations (POs) have until April 21 to review your data submissions before sending them to your auditors. Please make sure you’ve included all the measures you’ve chosen to report and double-check your data for accuracy. Reference the February and March 2025 AMP Technical FAQs to review common FinThrive data submission errors.
Thank you in advance for taking the extra time to validate your self-reported results. IHA is dedicated to giving accurate results, but we can’t accept appeals for incorrect results caused by PO self-reporting errors.
Health plans and providers: Submit audited clinical quality measures
Once your test files have been approved by FinThrive, please turn your attention to the following milestones:
April 21: Send your data to your auditor
Health plans and self-reporting POs: Send your data files to auditors for review before final submission to FinThrive.
May 2: Submit your audited data to FinThrive
Health plans and self-reporting POs: Email your auditor-locked data files to FinThrive at AMP@finthrive.com by 5 pm PDT.
Please see page 11 of the AMP Program Guide for a detailed data submission timeline.
Health plans: Review and sign off on Onpoint data quality reports
IHA takes a holistic approach to data quality by producing essential reports to help catch data issues further upstream.
What:Enhanced Validation Report I (EVR I) provides health plans a glimpse into trends in claims data.
March 19: Health plans received the EVR I report via email for review.
April 23: Sign-off due on EVR I.
What: Measure Trending Report (MTR) provides plans an opportunity to review measure results using a rolling four quarters of data (Q3 2023- Q2 2024 with Q3 2024 runout).
April 8-10: MTR findings that require further investigation are emailed to the health plan.
April 23: Responses to MTR findings by health plans due.
Note: Any applicable resubmissions identified from EVR I and MTR should be in validation pass by April 30 for inclusion in EVR II.
Please contact Onpoint and/or your AMP Client Success Manager with any questions or concerns.
Health plans: Submit Q1 2025 data files, 2024 annual Member Identifier, and Lab files
Q1 2025 data submission should include monthly eligibility between January 1 and March 31, 2025, and all claims paid or changed through March 31, 2025, that have not been previously submitted.
April 30: Get Q1 2025 data files and 2024 annual Member Identifier and Lab files in validation pass using DSG 8.2.
The 2024 annual Member Identifier (MI) and Lab files should include eligible members enrolled for at least one day between 01/01/24–12/31/24 and are included in your eligibility file submissions (no continuous enrollment criteria apply).
May 9: Submit the 2024 annual Cost file.
Health plans have until May 9 to get the 2024 annual Cost file in validation pass status using DSG 8.2 and the MY 2024 Cost File Value Set. The annual Cost file should include Cost results pertaining to services paid or changed between 1/1/2024–3/31/2025.
Please see the AMP Program Guide for the detailed data submission timeline on page 12.
in other news
Health plans: MY 2023 Atlas results now available
MY 2023 Atlas results were released for health plans on March 25th and are available for download on the Performance Reporting Portal (PRP). The latest Atlas release includes performance information for Commercial and Medicare Advantage populations to help health plans understand performance variation and identify opportunities for improvement. It also provides benchmarks by region and various market segments to enable performance tracking over time for clinical quality, hospital utilization, and cost of care.
Note: Atlas results use the data available when the process is kicked off and are generally not re-run. If files (Medical Claims, Pharmacy Claims, Member Eligibility, Supplemental Data, Cost) are resubmitted after a measurement year's kick-off date, the resubmission will not be included. For example, suppose if a health plan resubmitted their MY 2022 Cost file after the MY 2022 Atlas kick-off date of November 30, 2023. The resubmitted data will not be reflected in any subsequent Atlas release, including MY 2023.
in the pipeline
CDII Medical Group Health Care Quality Report Cards, 2024-2025 Edition
The preview period for updates to the 2024–2025 Edition Health Care Quality Report Cards using MY 2023 AMP results for Commercial HMO and Medicare Advantage is expected to begin in mid-May.
Prior to the preview period, organizations will be sent a link to access the Center for Data Insights and Innovation (CDII) Stakeholder page. To be added to CDII’s mailing list, send an email to cdiireportcard@ncqa.org.
IHA partners with CDII to publicly report AMP Commercial HMO and Medicare Advantage performance results each year. The report cards highlight overall performance and individual quality results for select clinical topics. The 2024-2025 Edition Commercial HMO report card also includes patient experience and total cost of care results.
Join us at APG’s Annual Conference in May
IHA is thrilled to be an exhibitor at the America’s Physicians Group Spring Conference 2025, May 14–16 in San Diego. If you’ll be there, be sure to stop by our booth!
Jeff Rideout, MD, IHA President and CEO, Dolores Yanagihara, MPH, General Manager of Performance Measurement Programs at IHA, and Ray Chicoine, Optum President and IHA Executive Committee member, will be participating in a breakout session titled, “How Physician Organizations in At-Risk Payment Models with Payers Achieve Superior Performance."
The discussion will center on an IHA analysis that assesses quality and cost performance by physician organizations that are in at-risk payment arrangements compared to non-integrated networks paid fee-for-service. We hope to connect with some of you in San Diego!
