ACR CONVERGENCE 2021—Rheumatologists should start to prepare now for the Centers for Medicare & Medicaid Services (CMS) transition to the Merit-Based Incentive Payment System (MIPS) Value Pathways (MVPs) in 2023, according to presenters at an ACR Convergence session, Business of Rheum: Ahead of the Payment Curve. Angus B. Worthing, MD, FACP, FACR, a partner with Arthritis & Rheumatism Associates, Washington, D.C., moderated the session.
The use of MVPs was first proposed in 2020. The program was slated to begin in the 2022 performance year, but was delayed until 2023 due to questions about implementation and the COVID-19 pandemic, said Kent “Kwas” Huston, MD, a rheumatologist with Kansas City Physician Partners, Kansas City, Mo. With the extra time, he said, “We can all take a breath and figure out how we can fit into it and be successful.”
Changes Under MVPs
According to the CMS, guiding principles are that MVPs:
- Have limited, connected, complementary sets of measures that are meaningful to clinicians;
- Include measures and activities that provide comparative performance data;
- Include measures using the Meaningful Measures approach and a patient voice when possible. “There is a strong interest in patient-reported outcomes over time,” Dr. Huston said;
- Reduce barriers to Alternative Payment Model (APM) participation by including measures that are part of APMs when feasible and by linking cost and quality measurement; and
- Support the transition to digital quality measurement.
Rheumatology has the advantage of being one of only seven areas with proposed MVPs in the 2023 pilot, said William F. Harvey, MD, MSc, FACR, clinical director of the Arthritis Treatment Center and chief informatics medical officer at Tufts Medical Center, Boston. The rheumatology MVP is under the category of Advancing Rheumatology Patient Care. Other proposed MVPs are:
- Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes;
- Advancing Care for Heart Disease;
- Optimizing Chronic Disease Management;
- Adopting Best Practices and Promoting Patient Safety Within Emergency Medicine;
- Improving Care for Lower Extremity Joint Repair; and
- Patient Safety and Support of Positive Experiences Within Anesthesia.
The seven areas will be part of the pilot MVPs in 2023.
Many of the quality measures will focus on things that rheumatologists track already, such as conducting tuberculosis screening before the first course of biologics, periodic assessment of rheumatoid arthritis functional status and safe hydroxychloroquine dosing. Each measure will have a unique code.