Quality reporting & Promoting Interoperability

Quality reporting: turn it on and who can use it

Quality reporting calculates the year’s quality measures (eCQMs) the way CMS does, for the whole practice or for one clinician, payer or site, shows which patients fall in each group, and creates the files you send to CMS or your ACO. It can also read quality files from another system. It lives in the Value-Based Care hub as a Reporting section next to Measures, the everyday worklist described in Quality review. Measures stays a live worklist; certified results and submission files come from Reporting.

1. Turn it on. In Admin → Additional Features, switch on Quality reporting and click Save Changes. It is off by default and needs Value-Based Care: turning Quality reporting on turns Value-Based Care on with it, and turning Value-Based Care off turns Quality reporting off.
2. Open it. Click Value-Based Care in the top bar, open the Quality & ACO tab, and choose Reporting (beside Measures, ACO attribution and HCC & RVUs).

Staff without the second permission see the results read-only, without the buttons. Hero installs each performance year’s measures; until it has, Reporting reads “The 2026 quality measures are not installed yet. Hero installs them for each performance year.”

Calculate the year’s measures and read the results

1. Choose the year and the patients. The year list reads, for example, 2026 performance year; it starts on the newest year Hero has installed. Patients is Chart and imported files (the default), Chart patients or Imported files. A person in an imported file who matches exactly one chart (same last name, first name, birth date and sex) is counted once.
2. Click Calculate. The status reads Calculating…, then, for example, “Calculated Oct 9, 3:00 PM · 412 patients (chart and imported files)”. Large calculations run in the background; the page updates on its own. Hero first re-reads your charts, so the results reflect the chart as it is now. The measures used are the ones ticked in Settings.
3. Read the table. One row per measure (with Population N when a measure has several, and Stratum rows where the measure splits by age or other groups). The columns are the groups each measure uses: Initial population, Denominator, Exclusions, Numerator, Numerator exclusions, Exceptions, Measure population, Measure population exclusions, then Performance rate.
4. Click a count to see who is in it. The list shows each person’s name, birth date, sex and whether they come from a chart or an imported file, with Open chart (chart patients only), Quality data and, if you may export, QRDA I for that patient’s file. A count of 0 cannot be opened.

Performance rate is (Numerator − Numerator exclusions) ÷ (Denominator − Exclusions − Exceptions), for example 83.4%; it reads — when nobody is left to count. The measurement period is January 1 to December 31 of the performance year in your practice’s time. A chart visit counts only when it has a billed visit code that was not cancelled.

Filters

After a calculation, Filters narrows the results without calculating again. Clinician and site: TIN, NPI, Provider type (taxonomy code), and the practice site street, city, state and ZIP. Patients: Payer (Medicare, Medicaid, Other government, Private insurance, Blue Cross / Blue Shield, No payment / self-pay, Other), age on the last day of the year, sex, race, ethnicity, and a problem by SNOMED CT code or value set. Fields combine with AND; several choices in one field combine with OR. Applied filters show as chips; the card title adds (filtered), and Clear all removes them.

Set who the report is for, then download the files

Settings

Settings opens Quality reporting settings (“Measures to calculate and who the report is for”):

• Measures — tick the measures to calculate. New practices start with CMS122, CMS2, CMS165, CMS125 and CMS130.
• Reporting for — the CMS program and level: MIPS, individual clinician (the default), MIPS, group (TIN), MIPS, virtual group, MIPS, APM entity, MIPS, subgroup, and the APP and APP Plus choices for individual clinicians, groups and ACO / APM entities.
• Identifiers — TIN (9 digits; Practice Info’s Tax ID is used when empty), Clinician NPI (for individual reporting), APM entity / ACO ID, Virtual group ID or Subgroup ID when the program needs one, and CMS EHR certification ID (15 characters).

Click Save settings. Closing with unsaved changes asks Discard unsaved changes?

Download

If the program needs an identifier you have not entered, the download says which one, for example “Group reporting needs the practice Tax ID.” Downloading patient files is recorded in the Audit Log.

Medicare ID. For Medicare patients, the patient files carry the Medicare Beneficiary Identifier taken from the Member ID on the patient’s Medicare or Medicare Advantage coverage, when it is a valid Medicare ID (11 letters and numbers, like 1EG4-TE5-MK73). There is nothing extra to enter; if a file has no Medicare ID, check the Member ID on the patient’s insurance.

The older draft links on Measures. If your practice also turned on Allow draft quality XML exports, the Export menu on Measures still offers QRDA III · totals and QRDA I · patient ZIP. With Quality reporting on, they hand you the files from the year’s latest Reporting calculation without filters, and they need the quality-reporting permission.

Import quality files and record what the chart does not show

Import quality files

Import quality files takes QRDA Category I files from another system or a test tool: “Charts are never changed.” Drop .xml files or a .zip of them (up to 200 files, 50 MB per upload). The summary says how many files were read, how many new patients, how many were combined with a patient already listed, and how many entries or files were already on file; a file Hero cannot read is listed with the reason.

When two files share a patient identifier but the name, birth date or sex differs, they appear under Possible duplicates. Choose Same person to combine them or Different people to keep both.

Quality data for one person

From a count in the results, click Quality data. It lists what Hero uses for that person’s measures: What, Codes, When and Result or reason, with a Not done tag on entries recorded as not done. Data from the chart is changed in the chart, not here.

1. Click Add entry and choose What it is (for example Procedure, Lab test, Assessment (screening, questionnaire) or Exam finding (e.g. blood pressure)) and When (practice time).
2. Find the code. Search the year’s measures by name (“Search by name, e.g. mammography, medical reason”), pick the value set, then Choose a code…. Add a Result and Unit if there is one.
3. Or record that it was not done. Tick It was not done (record the reason), then pick What was not done and the Reason the same way (for example a medical reason).
4. Click Record entry. Hero says “Entry recorded. Calculate again to include it.”

An entry you record here is kept with the person’s quality data only; it is not written to the chart, and later calculations keep it. You can remove entries recorded here and entries from imported files; entries from the chart cannot be removed. If the search finds nothing, it reads “Nothing found in this year’s measures.”

The Promoting Interoperability dashboard

The dashboard counts the Medicare MIPS Promoting Interoperability measures from your charts, for any period and for one clinician or your group (Tax ID), and shows who counted and why someone did not. Nothing is sent to CMS and no points are scored; it is the evidence behind what you report.

1. Turn it on. In Admin → Additional Features, switch on Promoting Interoperability dashboard and click Save Changes. It is off by default.
2. Open it. Choose Admin → Promoting Interoperability (under Money and admin). Practice administrators, the practice owner, and staff with “View Promoting Interoperability measure reports and the patients counted in them.” (included in Office Manager) see every clinician and the group. A physician sees their own measures: “You are seeing your own measures. An administrator can see every clinician and the group.”
3. Choose the period and who. From and To start on January 1 of this year through today, in your practice’s time (two years at most). Choose Clinician (it opens on your own row) or Group (Tax ID). Tick Include controlled substances in e-Prescribing to count them; they are left out by default.
4. Open a measure card. Each card shows the percent and, for example, “412 of 450 prescriptions”. Below, the list opens on Not met (also Met and All) with Patient, Date, Clinician, What counted and Result: a Met badge or the reason it was not met. When a measure other than patient access counts fewer than 100 in the period, its card adds “Fewer than 100 — you may claim the exclusion.”
5. Click Download CSV for every row of all four measures in the period (promoting-interoperability-…-to-….csv). Viewing the patient lists and downloading are recorded in the Audit Log.

With no clinicians set up, the page reads No clinicians yet; add the clinician in Admin → Physician Management first.

How each Promoting Interoperability measure is counted

A card note explains when something keeps a measure at zero, for example when Patient & third-party app access is off in Admin → Additional Features, or when electronic health record exchange by Direct messaging (Health information exchange) is off, so faxed or uploaded referrals and records cannot count.

Yes/no measures you attest to

This card is not scored; it shows what Hero recorded in the period to support your answers:

• Query of the prescription drug monitoring program — for example “12 of 14 Schedule II prescriptions had a PDMP check.” It counts Schedule II prescriptions whether or not the controlled-substances switch is on.
• Public health reporting — Immunization registry reporting, Syndromic surveillance reporting and Electronic case reporting, each Live, Testing or Not set up, with how many were sent in the period (test messages are not counted). See Public health reporting.