The new concept in 2023
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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.
MVP is a conceptual participation framework applying to future proposals beginning with the 2023 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.
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.
For the 2023 MIPS performance period, MVPs may be reported by individual MIPS eligible clinicians, multi-specialty groups, single-specialty groups, subgroups, or APM Entities.
Quality Reporting Requirements - 4 quality measures, including 1 outcome measure (or, if an outcome measure is not available, 1 high priority measure, included in the MVP, excluding the population health measure).
IA Reporting Requirements - an MVP Participant must report one of the following: two medium-weighted improvement activities; one high-weighted improvement activity; or participation in a certified or recognized patient-centered medical home (PCMH) or comparable specialty practice.
Cost Reporting Requirements - As in traditional MIPS, cost measures are calculated by CMS using administrative claims data.
Foundation Layer Reporting Requirements:
PI Reporting Requirements - The entire set of Promoting Interoperability measures, as a part of the foundation layer, are included in all MVPs.
Population Health Measures - As part of the foundation layer, at the time of MVP Registration, the Participant must select one Population Health Measure. The score from the selected measure is added to the Quality Performance Category of the MVP.
| QUALITY | IA | COST |
|---|---|---|
| 4 quality measures, including 1 outcome measure | 2 medium-weighted improvement activities OR one high-weighted improvement activity OR PCMH | no submission required |
| Entire Set of PI Measures | ||
| 1 Population Health Measure | ||
MVPs will be available for submission in performance year 2023. 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.
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