Healthmonix Advisor

Jon McNeill, CEO of DVx Ventures and former President of Tesla, opened HIMSS26 with a deceptively simple provocation: automation always comes last. In a conference hall full of people who flew to Las Vegas to talk about AI, his statement landed with force. 

HIMSS26 made 1 thing unmistakably clear: the center of gravity in U.S. health IT is shifting to FHIR‑native digital quality measures, interoperable data pipelines, and AI tightly embedded into clinical and administrative workflows.

For anyone working in the CMS quality and value‑based care ecosystem, the “nice‑to‑have” era is over. FHIR and digital quality measures (dQMs) are becoming the operating system.

This blog provides a detailed, visual, and measure-level comparison of 3 key CMS programs under the Quality Payment Program (QPP) framework — traditional MIPS, MIPS Value Pathways (MVPs), and the new Ambulatory Specialty Model (ASM) finalized in the 2026 Physician Fee Schedule Final Rule (CMS-1832-F). 

• Traditional MIPS (2017–present): Broad, clinician-driven program allowing flexibility in measure selection but limited comparability across specialties.
   
• MIPS Value Pathways (MVPs, 2023–2026): Transitional structure to align measures by specialty or condition, improving comparability and interoperability. 
  
  
• Ambulatory Specialty Model (ASM, launching 2027): Mandatory, condition-specific model targeting heart failure and low back pain specialists in select CBSAs.

This comparison highlights how CMS is evolving from flexible reporting (MIPS) to  aligned reporting (MVPs) to accountable, outcome-based measurement (ASM), with increasing use of digital quality measures (DQMs), FHIR data exchange, and data validation via DQMs. 

The Centers for Medicare & Medicaid Services (CMS) have released the 2024 Merit-based Incentive Payment System (MIPS) performance feedback and final scores. The 2024 performance year was characterized by stability, consistency, and restrained adjustments. 

Despite modest scoring variations, the 2024 feedback underscores CMS’ strategic redirection toward structured, specialty-aligned models — MIPS Value Pathways (MVPs), the Ambulatory Specialty Model (ASM), and broader CMMI-led innovation frameworks —to drive the next era of value-based reimbursement. 

For years, healthcare providers have navigated the complexities of the Merit-based Incentive Payment System (MIPS). They often find it to be a burdensome, one-size-fits-all compliance requirement that feels more like an administrative chore than a true measure of quality.  

But the landscape of quality reporting is undergoing its most significant evolution yet. The Centers for Medicare & Medicaid Services (CMS) is shifting away from the broad traditional MIPS framework toward a focused, specialty-specific model: MIPS Value Pathways (MVPs). 

CMS recently released updated MIPS quality measure benchmarks that affect how your performance translates into points for 2024 (https://qpp.cms.gov/api/frontend/benchmarks-csv/quality/2024). Below, we summarize what's new and provide complete lists of newly benchmarked measures, categorized by decile completeness. 

On Jan. 1, 2026, CMS will launch the Transforming Episode Accountability Model (TEAM), a mandatory 5-year program designed to hold hospitals accountable for both the cost and quality of care delivered around major surgical episodes. TEAM covers 5 high-volume, high-cost procedures, creates two-sided risk, and ties financial performance to outcomes like readmissions, safety, and patient-reported results. 

Are you feeling overwhelmed by MIPS reporting requirements? You’re not alone. With the 2025 performance threshold holding steady at 75 points and hundreds of measures to sort through, many providers are turning to MIPS Value Pathways (MVPs) for a more streamlined — and smarter — approach. 

The frantic pace, high-stakes decisions, and unpredictable patient flow of the emergency department make it a unique and challenging environment in healthcare. For years, the Merit-based Incentive Payment System (MIPS) program has presented a formidable obstacle for emergency physicians, and now the Cost category will have a measure just for emergency medicine in your 2024 feedback. This part of MIPS, which assesses the total cost of care for patients, can feel disconnected from the realities of emergency medicine, where the primary goal is rapid stabilization and appropriate disposition, not cost control. 

On July 10, 2025, CMS released the CY 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule. While CMS characterized 2026 as a “stabilization year,” the Proposed Rule brings several notable updates to the Merit-Based Incentive Payment System (MIPS), particularly around MIPS Value Pathways (MVPs), the Cost performance category, and registry participation.  

These changes are crucial for providers aiming to protect their reimbursement, streamline reporting, and improve performance.