Healthmonix Media Coverage

Tough year, big change: MIPS players challenged on scores, then by MVPs

Posted by Healthmonix on Dec 3, 2021 10:19:36 AM


The delay on a full switchover to the MIPS Value Pathways (MVP) program may relieve anxious partici­pants, but experts say it's merely a reprieve in a Quality Payment Program (QPP) that is slated to undergo funda­mental change in coming years. In 2022, in what may be the final year of traditional MIPS reporting, providers will face thresholds that are higher than ever, and participants who've been breezing through may find rougher going.

Originally scheduled to begin in 2021, then in 2022, MVP - a major rethinking of reporting requirements for the program - will start for MIPS participants with the 2023 performance/2025 reporting year, according to the final 2022 Medicare physician fee schedule (PEN 7/26/21).

Under MVP, MIPS performance will be reported in new categories that will be relevant to specific specialties, medical conditions or episodes of care. An MVP subgroup is defined as "a subset of a group which contains at least one MIPS-eligible clinician and is identified by a combination of the group TIN, the subgroup identifier and each eligible clinician's NPI," according to CMS.

At first glance, MVP looks like a reduction in provider effort: As described in new CMS materials, MVP reporters who currently report at least six Quality measures will report four Quality measures, one of which must be an outcome measure. They will report two medium-weighted or one high-weighted Improvement Activity (or, for some reporters, membership in a patient-centered medical home), rather than
four medium- or two high-weighted activities currently, and the same seven required Promoting Interoperability measures (e.g., security risk analysis, e-prescribing) as now. Cost will still be calculated by CMS.

But you'll find significant changes to the standards forreporting: Participants will be slotted into condition-specific pathways that will dictate the measures they report.They also will be assigned population health measures.

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Topics: MACRA & MIPS, Cost Performance Category, MIPS Value Pathways, 2022 PFS Final Rule