This bill, known as the "Health Care Efficiency Through Flexibility Act," aims to improve quality reporting for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) by amending the Social Security Act. It mandates that for performance years 2025 through 2029, the Secretary of Health and Human Services must ensure the availability of specific quality measure collection types, including electronic clinical quality measures (eCQMs), MIPS clinical quality measures, and Medicare Clinical Quality Measures for ACOs. Furthermore, for performance years beginning on or after January 1, 2025, the bill provides flexibility regarding data completeness requirements. The Secretary cannot deem an ACO's data unrepresentative solely because it excludes data from an ACO participant, provided the ACO's submission otherwise meets requirements and the participant was unable to collect data using the ACO's chosen method. This provision helps accommodate challenges faced by individual participants within an ACO. The legislation also establishes a pilot program for digital quality measure reporting for performance years 2028 through 2032. Under this program, the Secretary will select participating ACOs to report a limited number of specified quality measures using a digital collection type. Crucially, ACOs selected for the pilot will be waived from reporting other quality measures normally required, and the data submitted under the pilot will not be used to determine their quality performance standards or MIPS scores for participating providers. The Secretary is directed to provide technical assistance to pilot participants and, by December 31, 2032, must publicly release an analysis of the program, recommendations for increasing digital submissions, and a proposed timeline for requiring such submissions in the future. This pilot aims to test and evaluate the feasibility and effectiveness of digital quality measure reporting before broader implementation.