Will MVPs bring a simpler future?

Will MVPs bring a simpler future?There’s nothing simple about the Medicare Physician Fee Schedule, including the Merit-based Incentive Payment System, or MIPS. But credit the Centers for Medicare and Medicaid Services (CMS) for trying.

For 2021, CMS has proposed a next-generation MIPS program, called MIPS Value Pathways (MVPs). The goal is to move away from siloed activities and measures, and move toward an aligned set of measure options that are relevant to a clinician’s scope of practice.

Currently, MIPS-eligible physicians must submit information on a variety of measures in each of four categories: Cost, Quality, Promoting Interoperability, and Improvement Activities. The MVP framework would align and connect measures and activities across all four. A clinician or group would be in one MVP associated with their specialty or with a condition, reporting on the same measures and activities as other clinicians and groups in that MVP.

“We believe the MVP framework would help to simplify MIPS, create a more cohesive and meaningful participation experience, improve value, reduce clinician burden, and better align with APMs [Alternative Payment Models] to help ease the transition between the two tracks,” CMS said in a statement.

Simple, right? That remains to be seen.

“We recognize that this would be a significant shift in the way clinicians may potentially participate in MIPS,” says CMS. “Therefore we want to work closely with clinicians, patients, specialty societies, stakeholders, third parties and others to establish this new framework.”

How MVPs would change physician reporting and reimbursement

  Current state of MIPS (2020) New MIPS Value Pathways Framework (in next 1-2 years) Future state of MIPS (in next 3-5 years)
Overall direction of program · Many choices

· Not meaningfully aligned

· Higher reporting burden

· Cohesive

· Lower reporting burden

· Focused participation around pathways that are meaningful to clinician’s practice/specialty or public health priority

· Simplified

· Increased voice of the patient

· Increased CMS-provided data

· Facilitates movement to Alternative Payment Models (APMs)

Example: Diabetes · Endocrinologist chooses from same set of measures as all other clinicians, regardless of specialty or practice area

· Four performance categories (Cost, Quality, Promoting Interoperability, Improvements Activities) feel like four different programs

· Reporting burden higher and population health not addressed

· Endocrinologist reports same “foundation” of Promoting Interoperability and population health measures as all other clinicians, but now has a MIPS Value Pathway with measures and activities that focus on diabetes prevention and treatment.

· Endocrinologist reports on fewer measures overall in a pathway that is meaningful to their practice

· CMS provides more data; reporting burden on endocrinologist reduced

· Endocrinologist reports on same foundation of measures with patient-reported outcomes also included.

· Performance category measures in endocrinologist’s Diabetes Pathway are more meaningful to their practice.

· CMS provides even more data (e.g. comparative analytics) using claims data and endocrinologist’s reporting burden even further reduced.

Source: Centers for Medicare and Medicaid Services