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Evolution of Medicare’s Merit-Based Incentive Payment System: MIPS Value Pathways

Ruth Jessen Hickman, MD  |  December 1, 2022

The ACR created several of the outcome measures, which they submitted to the CMS for approval. Said Dr. Harvey, “We take the things that are routinely done [in rheumatology practices], we measure them and get you credit for it. We’re trying not to have you report on things like diabetes that wouldn’t fit with your practice.”

Many physicians, especially those who are part of a larger multi-specialty group or health system, may already be meeting several of the criteria in the Promoting Interoperability category, such as performing e-prescribing, using prescription drug monitoring programs and utilizing immunization registries, Dr. Harvey pointed out.

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In the Improvement category, which measures activities that improve clinical practice, one must pick two medium or one highly weighted activity. These include activities related to tobacco cessation, telehealth services, electronic health records and capturing patient outcomes, better engagement of patients through patient portals and others. Dr. Harvey noted that here too, many practices already perform some of these activities.

Dr. Harvey explained that the Cost category is the most complex, as it is based on a very complex formula that involves risk adjustments. However, clinicians do not need to do anything to submit, because the CMS will automatically calculate this based on the medical claims it receives.

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A new component is that clinicians must also pick a population health measure when they register for an MVP. The CMS will automatically calculate this based on administrative claims data. This involves either a measure related to 30-day hospital readmission or a measure of hospital admission rates for patients with multiple chronic conditions.

How & Why to Try the Rheumatology MVP

For clinicians unsure about whether to try the MVP in 2023, Dr. Harvey suggested considering several factors. For example, some might already be tracking the performance of quality measures that are measured as part of an MVP and know they are performing well in these measures. For such clinicians, a transition to an MVP in 2023 might be beneficial. He added, “There might be some bugs, because it is a new program, and this is the first year it is being implemented. But if you are forward thinking, I encourage you to get in early on this.”

Participants can also take advantage of the free RISE registry, the largest electronic health record-enabled rheumatology registry in the U.S. Clinicians can connect their electronic health records systems to RISE to reliably and consistently track the quality of the care that they provide. Dr. Harvey added, “It supports all the submissions of MIPS that are required, and we created the rheumatology MVP with the use of RISE in mind. You just do your daily work, and the RISE registry keeps track of everything for you.”

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Filed under:ACR ConvergenceMeeting ReportsQuality Assurance/Improvement Tagged with:ACR Convergence 2022MIPSRISE registry

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