MIPS 2020 Final Rule: MIPS Value Pathways
The Merit-based Incentive Payment System (MIPS) Value Pathways is a participation framework for MIPS that is set to begin with the 2021 Performance Period. According to the Centers for Medicare & Medicaid Services (CMS), the goal is “to move away from siloed activities and measures and move toward an aligned set of measure options more relevant to a clinician’s scope of practice that is meaningful to patient care.”
Instead of choosing measures across different categories, CMS will create a ”pathway” of related measures that are relative to an eligible clinician’s scope of practice or a specific disease. It will be predetermined as to what will be more relevant to a specific specialty – with potentially fewer measures that are aligned to hopefully reduce burden on providers, drive value through meaningful participation and, most importantly, improve outcomes for patients.
CMS has stated that they have worked with providers and practices, specialty societies and third parties to establish the frameworks. They have not made any proposals yet as to whether participation in the pathways will be mandatory or optional for the first year. More details are expected to be released in late 2020.
CMS provides some potential situations on its website to illustrate how pathways might look for treating diabetes or by using a surgical example at qpp.cms.gov/mips/mips-value-pathways. In the diagrams, it shows that all four categories from previous performance years will continue to be reported on, but in a different framework.
Information for this article was taken from the MIPS 2020 Final Rule webinar presented in January by the Quality Reporting Engagement Group. The team is ready to help practices with all your MIPS needs, from submission assistance for 2019 reporting to a full-service consulting partnership for 2020. Contact them at firstname.lastname@example.org.