The MIPS Value Pathways (MVP) Program

Originally presented as part of the 2020 Final Rule, the MIPS Value Pathways (MVP) program continues to receive significant attention as it evolves. MVPs will be officially launched in 2023 and require providers to report on a smaller set of measures. Theoretically, by limiting the volume of measures, CMS will be able to effect change more broadly. In addition, this is their attempt to continuously remove burdensome aspects of the program.

From CMS:

“Each MVP includes select measures and improvement activities, available within the MIPS inventory, that are linked by a common clinical theme. Additionally, each MVP identifies possible specialties for reporting. We believe the clinical topic represented by the MVP may be meaningful for clinicians within those identified specialties. If a clinically relevant MVP isn’t available for your scope of care, you can still report through traditional MIPS as an individual, group, virtual group, or an Alternative Payment Model (APM) entity.”

These changes aren’t going to be made in a vacuum. CMS is currently seeking stakeholder feedback and comments on all MVPs and hosting multiple MVP Development Kick-Off Webinars. All stakeholders are encouraged to attend or watch the recorded sessions:

As mentioned, while MVPs will be available in 2023, they will be fully replacing the MIPS program in 2025. For now, MVPs are running concurrently with MIPS. You can choose to report an MVP while still reporting MIPS the way you always have, and CMS will accept the higher of the two scores and allocate your payment adjustment according to the best score. So why not try out MVPs now, while they are not “required” so you have time to make the adjustment?

What do MVPs look like?

Essentially, they are a repackaged version of MIPS in that they still contain many of the quality measures everyone is familiar with in the MIPS program. Same goes for the Promoting Interoperability (PI), Improvement Activities (IA) and Cost categories. The difference is, each MVP is per your specialty. One MVP contains a cluster of very specific, specialty related quality measures, IA, Cost and PI measures (when and if applicable to your specialty.) Let’s review an example of one of the currently available MVPs:

Optimizing Chronic Disease Management:

8 Quality measures to choose from. You only need to pick 4 of these if you choose this MVP:

  • Q006: Coronary Artery Disease (CAD): Antiplatelet Therapy
  • Q047: Advance Care Plan
  • Q107: (CMS eCQM ID: CMS161v10) Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
  • Q118: Coronary Artery Disease (CAD): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%)
  • Q119 (CMS eCQM ID: CMS134v10) Diabetes: Medical Attention for Nephropathy
  • Q236: (CMS eCQM ID: CMS165v10) Controlling High Blood Pressure
  • Q398: Optimal Asthma Control
  • Q438: (CMS eCQM ID: CMS347v5): Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
  • Q483: Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure

11 Improvement Activities to choose from. You only need to pick two medium weighted or one high weighted of these if you choose this MVP:

  • IA_AHE_3: Promote use of Patient-Reported Outcome tools: high
  • IA_BE_4: Engagement of patients through implementation of improvements in patient portal: medium
  • IA_BE_16: Promote self-management in usual care: medium
  • IA_BE_22: Improved practices that engage patients pre-visit: medium
  • IA_CC_2: Implementation of improvements that contribute to more timely communication of test results: medium
  • IA_CC_12: Care coordination agreements that promote improvements in patient tracking across settings: medium
  • IA_CC_13: Practice improvements for bilateral exchange of patient information: medium
  • IA_CC_14: Practice improvements that engage community resources to support patient health goals: high
  • IA_EPA_1: Provide 24/7 access to MIPS eligible clinicians or groups who have real-time access to
    patient’s medical record: high
  • IA_PSPA_19: Implementation of formal quality improvement methods, practice changes or other practice improvement processes: medium
  • IA_PCMH: Electronic submission of Patient Centered Medical Home accreditation: N/A

Promoting Interoperability & Population Health: Submit the required Promoting Interoperability measures (the same as under traditional MIPS) listed below. Bonus points are available for reporting measures that aren’t required. Many of the same special scenario reweights exist for this category (eg. PTs are exempt and automatically reweighted to quality) For Pop Health details, refer to this guide; similar to cost, it is automatically calculated:

  • PI_INFBLO_1: Actions to Limit or Restrict Compatibility or Interoperability of CEHRT (previously Prevention of Information Blocking)
  • PI_ONCDIR_1: ONC Direct Review Attestation
  • PI_ONCACB_1: ONC-ACB Surveillance Attestation
  • PI_EP_1: e-Prescribing
  • PI_EP_2: Query of the Prescription Drug Monitoring Program (PDMP)
  • PI_PEA_1: Provide Patients Electronic Access to Their Health Information
  • PI_HIE_1: Support Electronic Referral Loops By Sending Health Information
  • PI_HIE_4: Support Electronic Referral Loops By Receiving and Reconciling Health Information
  • PI_HIE_5: Health Information Exchange (HIE) Bi-Directional Exchange
  • PI_PHCDRR_1: Immunization Registry Reporting
  • PI_PHCDRR_2: Syndromic Surveillance Reporting
  • PI_PHCDRR_3: Electronic Case Reporting
  • PI_PHCDRR_4: Public Health Registry Reporting
  • PI_PHCDRR_5: Clinical Data Registry Reporting
  • PI_PPHI_1: Security Risk Analysis
  • PI_PPHI_2: Safety Assurance Factors for EHR Resilience Guide (SAFER Guide)

Regarding Cost Scoring, no one selects cost measures during MVP registration. CMS calculates performance on all the cost measures included in the MVP based on available Medicare claims data.

  • TPCC_1: Total Per Capita Cost (TPCC)

All MVPs and their toolkits can be found in the QPP resource center here and select the 2023 dropdown menu.

And, here is a helpful video from CMS detailing everything you need to know about MVPs.

Don’t wait for MVPs to be mandatory. Get started in 2022 to see how well you perform, affording you the opportunity to be more successful in 2023 and beyond!