For the 2024 Performance Year (PY), Providers can select from 198 quality measures approved by CMS. Data needs to be collected and submitted for each selected quality measure for the entire 2024 calendar year.

To meet the Quality performance category requirements, a MIPS eligible provider, group, or virtual group can report:

• 6 quality measures (including at least one outcome measure or high priority measure in absence of an applicable outcome measure) for the 12-month performance period; OR
• A defined specialty measure set (if the measure set has fewer than 6 measures, all measures within that set need to be submitted)

Data Completeness

For 2024, the data completeness requirement is 75%. Providers need to report performance or exclusion/exception data for at least 75% of patients or encounters that are eligible for the measure’s denominator.

What’s New with Quality in 2024?

• The quality performance category weight remains 30% for individual MIPS eligible providers, groups, and virtual groups participating in traditional MIPS.
• There are no bonus points for reporting additional outcome and high priority measures, or end-to-end electronic reporting.
• CMS finalized a total of 198 quality measures for the 2024 performance period.

What’s New with Promoting Interoperability (PI) in 2024?

What’s New with Improvement Activities (IA) in 2024?

• Addition of 5 new IAs, it includes an MVP-specific improvement activity titled “Practice-Wide Quality Improvement in MIPS Value Pathways”.
• Modification of 1 existing improvement activitiesRemoval of 3 existing improvement activities.

For the 2024 PY, the Cost category is included in the final score and is weighted for 25% of the final score. Cost will be calculated directly by CMS and therefore no submission will be required.

• Reporting period will be for the full PY in 2024.
• Individual eligible providers or groups will be scored on 29 measures included in the Cost performance category.
• Addition of 5 new Episode-based measures.
• Medicare Spending per Beneficiary (MSPB), Total per Capita Cost measure for all attributed beneficiaries (TPCC) and 27 episode-based cost measures.
• CMS will calculate Cost category score based on administrative claims data.

Reweighting of Performance Categories

CMS would apply automatic reweighting to the following, beginning with the 2023 performance period:

• Clinical social workers
• Small practices
• No reweighting for certified nurse midwives.

Merit-Based Incentive Payment (MIPS) Background

The Centers for Medicare and Medicaid Services (CMS) introduced the Quality Payment Program in 2015 with two tracks: MIPS and Advance Payment Model (APM).

In MIPS, performance-based payment adjustments are made for the services provided to Medicare patients based on a Final Score. Performance is measured across 4 areas – Quality, Improvement Activities (IA), Promoting Interoperability (PI) and Cost.

As the MIPS program has matured, the difficulty of avoiding payment penalties has been steadily increasing. Also, clinicians and stakeholders have expressed that MIPS is overly complex.

What are MVPs?

MVP is a conceptual participation framework applying to future proposals beginning with the 2024 performance year. The MVP framework aims to align and connect measures and activities across the Quality, Cost, PI, and IA performance categories of MIPS for different specialties or conditions. MVPs are based on a specialty, medical condition, or episode of care and are established through the CMS rule- making process.

How are MVPs going to make reporting more meaningful?

Traditional MIPS reporting can be confusing. Scoring logic and the reporting requirement of each category are unique. In addition, there are many measures and activities to choose from, many of which are not relevant to a clinician’s specialty.

The introduction of MVPs is a landmark change aimed at reducing the reporting burden while also moving away from certain activities and measures. Reporting on an aligned set of performance measure options relevant to a clinician’s scope of practice is more meaningful to clinicians, allows patients and caregivers to make more informed choices using comparative performance data and places greater emphasis on patient care. MVPs also reduce barriers to APM participation and support the transition to digital quality measures.

For multispecialty groups, the MVP subgroup reporting option provides a way to report performance information meaningful to the various specialties and teams within the group.

Who can report MVPs?

For the 2024 MIPS performance period, MVPs may be reported by individual MIPS eligible clinicians, multi-specialty groups, single-specialty groups, subgroups, or APM Entities.

First steps to prepare for MVP reporting

MVPs will be available for submission in performance year 2024. Being informed about the nuances of the evolution of MVPs will enable clinicians to choose the best possible option for their reporting, aiming to earn positive payment adjustments, simplify the reporting and enable better focus on patient care.

1. CMS has already finalized 16 MVPs in 2024 Final Rule. Identify whether any of them are related to your specialty:
• Advancing Cancer Care
• Advancing Care for Heart Desease
• Optimal Care for Kidney Health
• Optimal Care for Patients with Episodic Neurological Conditions
• Supportive Care for Neurodegenerative Conditions
• Value in Primary CareAdvancing Care for Heart Disease
• 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
• Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes
• Focusing on Women’s Health
• Quality Care for the Treatment of Ear, Nose and Throat Disorders
• Prevention and Treatment of Infectious disorders including Hipatitis C and HIV
• Quality Care in Mental Health and Substance use disorders
• Musculoskeletal Care and Rehabilitative Support
2. If you identify a relevant MVP, check if you are already submitting for the quality measures. If so, how do your previous year’s scores look like? Then look at the listed IAs to see if you are already reporting on them.
3. Ideas for an additional MVP that supports meaningful measurement of a specialty, condition or public health priority that is meaningful to patient care can be brought to CMS as they have published guidelines for Candidate Development and Submission.
4. It is expected that CMS will publish more MVPs in the proposed rule 2025. After reviewing if any of the MVPs pertain to your specialty/practice, send your comments to CMS.
5. Remember that all PI measures are mandatory unless exceptions are claimed. Review and update your health-IT systems as per the requirements.