As we approach the MIPS 2022 reporting deadline, new information about the APP rollout and data integration has become apparent, especially concerning data completeness requirements and QRDA III file types.

We know from CMS that QRDA is defined as:

The Quality Reporting Document Architecture (QRDA) is the data submission standard used for various quality measurement and reporting initiatives. QRDA creates a standard method to report quality measure results in a structured, consistent format and can be used to exchange eCQM data between systems.

What is the difference between a QRDA I and a QRDA III?

QRDA III is aggregate data of denominator and numerator. This includes:
  • aggregate measure score
  • breakdown by populations for measure numerator, denominator, exclusions
QRDA I is patient-level data, not aggregated, allowing for a full view of the universe of patient data. This data includes:
  • Provider
  • Patient
  • Measures that are being reported on
  • Patient-level data & reporting parameters
  • Detailed clinical data (e.g. clinical observations and interventions)
A visual representation of this data is shown below.


QRDAIIIs do not have patient-level information and instead describe aggregate measure information. The arrows point to the breakdown of populations for a measure in Initial Patient Population, Numerator, and Denominator. QRDA-image-1


We see patient demographics, individual encounters, and various patient measures in QRDA I files. We can leverage and deduplicate multiple files from different clinicians using these fields such as patient ID, date of birth, and date of service, to better complete the requirements from CMS. The simple answer is that in the APP, QRDA III’s are no longer an option as a starting point for ACO/APP level reporting. Have no fear, Patient 360 has the solution to your reporting needs through alternative reporting methods, including QRDAI (an individual Patient-level report), which is exportable by EHRs that are CEHRT 2015 certified, as well as other formats that are commonly supported by non-certified EHRs as long as those formats do not manually manipulate the data and utilize the eCQM version of the measure. Patient 360 provides the tools for:
  • Data Acquisition through API, sFTP, and drag-and-drop
  • Data Aggregation across EHR’s meeting APPs eCQM/CQM APP requirements
  • ACO-level analytics as well as TIN-level, and NPI-level analytics to provide insights and identify gaps
  • Comparison against MIPS benchmarks for Score Calculation
  • APP Data Submission to CMS via the CMS submission API for 3 eCQM/CQM measures
  • Year-over-year comparisons as program participation progresses