Healthmonix Media Coverage

New Model for MIPS is Coming, While Advanced APMs Get a Tough Break

Posted by Healthmonix on Jul 25, 2022 11:14:00 AM

by Roy Edroso

For CY2023 changes to the Quality Payment Program (QPP) and Merit-based Incentive Payment System (MIPS), CMS focuses its attention on the MIPS Value Pathways (MVP), a new measures regimen that begins on a voluntary basis in 2023. A mandatory adoption deadline remains fluid.


CMS is serious about promoting the MVP program, proposing to open its measures to public comments and hold an "annual public facing webinar" on the subject.

The agency announced five new MVPs in the proposed rule:

• Advancing Cancer Care.
• Optimal Care for Kidney Health.
• Optimal Care for Neurological Conditions.
• Supportive Care for Cognitive-Based Neurological Conditions.
• Promoting Wellness.

The previously announced MVPs include:

Advancing Care for Heart Disease; Optimizing Chronic Disease Management; Advancing Rheumatology Patient Care; Adopting Best Practices and Promoting Patient Safety within Emergency Medicine; Improving Care for Lower Extremity Joint Repair; Patient Safety and Support of Positive Experiences with Anesthesia; and Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes.

Owing to the high level of condition and specialty specificity of the MVPs, CMS proposes to established MVP "subgroups" under which groups with diverse specialties or patient populations can register. In 2023, such groups can register as subgroups or as regular MVP reporters, but CMS says subgroups will be mandatory for eligible providers in multispecialty groups who choose to participate in MVP starting in 2026.

Each group with a taxpayer identification number (TIN) would be able to create multiple subgroups, but eligible providers with their own TlN and national pro­vider identifier (NPI) would be limited to one subgroup. Subgroups would be scored on their affiliated group's population health measure and cost measure scores, if appropriate, as well as on their MVP performance.

"This issue of how to determine the specialty of a provider remains open to discussion, as we recognize that the registered specialty in PECOS is often incorrect," says Lauren Patrick, president and CEO of qualified registry Healthmonix in Malvern, Pa. "CMS has now proposed reviewing claims to determine specialties as we move forward."

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Topics: CMS, MIPS Value Pathways, 2023 PFS Proposed Rule