Key Takeaways
-
A new MIPS Value Pathways framework is available for outcomes reporting.
-
The program will eventually replace the Merit-based Incentive Payment System (MIPS).
-
Orthopedic practices can focus more on specialty-specific measures.
Patient outcomes reporting is more important than ever for orthopedic practices. Implementing a reporting program is not only required by CMS, it also ties directly to reimbursement and quality care. Now, with the new MIPS Value Pathways reporting option, it’s even more critical to understand the ins and outs of this government requirement.
Learn more about navigating the shift to MVPS at our upcoming webinar. In the meantime, here’s what you need to know.
What is MIPS?
The Merit-based Incentive Payment System (MIPS) is a CMS quality payment program that evaluates clinicians based on performance. Established in 2017, MIPS aims to improve the quality of care provided to Medicare beneficiaries while also controlling healthcare costs. Eligible clinicians who bill Medicare above a certain threshold must participate in MIPS.
Under MIPS, practices must report on four categories: Quality, Promoting Interoperability, Cost, and Improvement Activities. Traditionally, Quality has been the toughest category to track, requiring practices to report on six measures in this category.
Practices must achieve 60 points in the quality category to either earn a MIPS bonus payment or avoid a MIPS penalty. In the past, practices could gain bonus points outside of quality measures—for example, by reporting end-to-end from the EHR.
What's changing with MIPS?
Now, CMS is making it more difficult to succeed with traditional MIPS, by:
- Discontinuing end-to-end bonus points
- Discontinuing bonus points for high-priority measures
- Devaluing points on many measures
- Raising the minimum point score needed to avoid penalties
CMS is using these MIPS changes as a method to drive changes in physician behavior. With these changes, CMS wants to incentivize the switch to a new framework called MIPS Value Pathways (MVPs). Eventually, CMS plans to sunset traditional MIPS.
What are MVPs?
MVPs are a more flexible reporting option for clinical specialties such as orthopedics. MVPs require fewer measures, so practices can streamline reporting and focus on specialty-specific measures. The goal of MVPs is to reduce the burden on clinicians while still promoting high-quality care.
How should orthopedic practices approach MVPs?
Whether your orthopedic practice has already participated in MIPS or is playing catch-up, now is the time to plan for MVPs implementation. While MVPs are currently optional, CMS has indicated they will become required in performance year 2026.
The good news: MVPs offer the opportunity to focus on outcomes relevant to your specialty, while demonstrating high-quality care delivery and efficiency. Orthopedic specialties benefit from MVPs tailored to your practice, allowing you to report on measures directly aligned with your patient population and clinical workflows.
How can PatientIQ help with MVPs?
One of the requirements of MVPs is that practices must report an outcome measure. Both researchers and the medical community are embracing patient-reported outcome (PRO) measures to achieve this requirement. These measures are key to outcome evaluation and reimbursement throughout healthcare.
Enabling successful PRO programs is the core of PatientIQ's solution. PatientIQ can automate much of the outcomes reporting process, simplifying both collection and reporting. Our experienced team works with orthopedic practices across the U.S. to implement outcomes reporting programs and support their shift to MVPs.
How can I learn more about the shift to MVPs?
Watch our webinar, where we review specific examples and next steps for your practice.
