CHICAGO—Whether it’s MIPS, MVP (not the sports designation), QPP or another acronym, keeping track of quality measures for federal reporting purposes can get confusing. Yet there’s real value in understanding the different measures that rheumatology practices can track to improve care for your patients.
That’s what panelists discussed during the ACR Convergence 2025 session MIPS and MVPs: What Clinicians Need to Know for 2026 and Beyond. Four panelists shared their unique perspective on MIPs, MVPs and the ACR RISE registry.
Understanding MIPS, MVPs & More
A basic understanding of the various government quality programs and acronyms makes it easier to put them in today’s context. Beth Radtke, MS, director of registry operations for the RISE Registry at the ACR, provided a brief rundown, noting the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015 to move payments from a fee-for-service to a value-based model.
That led to the creation of QPP, or the CMS Quality Payment Program, which rewards physicians for participation through either a Merit-Based Incentive Payment System (MIPS) or an Alternative Payment Model (APM).
Physicians in MIPS are scored on quality, cost, promoting interoperability and improvement activities. Each area has a different numeric weight that has changed through the years, but they all equal 100 overall.
Clinicians take part in an APM if they are part of an accountable care organization (ACO) or a bundled payment model, Ms. Radtke said.
In 2023, CMS added MVPs (or MIPS Value Pathway) under the QPP to streamline reporting and make it more relevant to certain specialties, reduce the reporting burden and improve alignment with clinical practice, Ms. Radtke said. “Each MVP is tailored to a specialty to make QPPs more meaningful,” she explained.
Eventually, CMS will phase out traditional MIPS in favor of MVPs, the latter of which is currently voluntary. Practices also can report both MIPS and MVPs right now, and CMS will use a practice’s highest numbers for payment.
Three measures within the ACR’s RISE data registry are part of MVPs: disease activity for psoriatic arthritis, serum urate target for gout, and safe hydroxychloroquine dosing. Although only a small number of physicians reported MVPs in 2023, many rheumatologists were early adopters, Ms. Radtke said.
RISE continues to grow as a conduit for MIPS and MVP reporting. RISE currently consists of more than 190 practices, 1,019 active clinicians and 3.7 million active patients.
This year, RISE also introduced one new measure, ACR17, for adult rheumatoid arthritis patients who are receiving their first course of therapy with a disease-modifying anti-rheumatic drug.
Using RISE: One Provider’s Point of View
Nandini Setia, MD, with Articularis Rheumatologist Specialists in Atlanta, shared the benefits and occasional challenges her practice has had using RISE. Her physician-owned practice has locations in multiple states and uses three different electronic medical records (EMRs). The practice reports QPP data for MIPS, MVPs and also via APMs as part of an ACO. These are done through RISE. Why do practice leaders report all three? “There’s a method to this madness,” she said.
First, RISE data is captured by all of their EMRs, which standardizes the data practice-to-practice, so there’s not a significant amount of extra time involved. Reporting data through these different areas helps the practice ensure alignment with quality of care standards, and helps its business partners see its value. Tracking data through the different pathways can help practice leaders and payers identify the pathway with the strongest results.
Practice leaders chose four RISE-specific metrics to adopt:
- a gout serum urate target less than 6.0 mg/ml;
- disease activity measurement for patients with psoriatic arthritis;
- safe hydroxychloroquine dosing (less than or equal to 5 mg/kg); and
- hepatitis B safety screening.
A review of their data in August led to some interesting insights, Dr. Setia said. First, the practice was not recording some of the processes they thought they were recording, such as RAPID3s. Recording that was part of their legacy EMRs, and practice leaders had to retrain medical assistants on how to record that information with new software.
Next, they also realized certain practices were doing well with some measures and could train other practices on how to raise their scores in those areas. “That stopped us from reinventing the wheel,” she said.
Practice leaders also realized the way each rheumatologist documents patient data is different, a realization she hopes will lead to future streamlining.
Going through the reporting process helped practice leaders emphasize quality as a process and signals to staff and patients that they are driven to quality care, Dr. Setia said. Future challenges include how to embed data collection into workflows as much as possible, helping medical assistants decide when certain things (like RAPID3s) can be skipped, and being mindful of the extra burden on staff.
Looking Ahead to 2026
Tom Tack, senior director of RISE at the ACR, shared some of the feedback the ACR gave CMS regarding proposed changes for MIPS and MVPs in 2026. Although there were no significant changes for the traditional MIPS program, there were several changes proposed for the rheumatology MVP, such as adding hepatitis B screening (ACR10) and tracking rheumatoid arthritis patients with low disease activity/remission (ACR16).
CMS leaders also proposed adding core data elements to each MVP by the 2027 payment year, which the ACR stated it was against because it potentially reduces the ability of each practice to report on those individual measures. CMS leaders also proposed adding well-being and nutrition, which the ACR commended as an important step toward disease prevention, but added that patient-reported outcomes are hard to collect and not usually captured in the EMR.
The upcoming year will bring the launch of a new vendor for RISE. The updated registry will go beyond a new look and feel, Mr. Tack said. This will include alerts to make quick changes, identifying specific patients for intervention, a better focus on quality improvement, and patient- and practice-level data. Practice leaders also will have access to their performance against all 25-plus measures in the dashboard.
“The intent is that RISE becomes a strategic partner to advocate change and deliver better care,” he said.
During the session, Puneet Bajaj, MD, MPH, associate professor in the Department of Internal Medicine and member of the Division of Rheumatic Diseases at UT Southwestern Medical Center in Dallas, also shared his perspective on the current and future state of RISE and opportunities for engagement. He spoke to the need for more academic medical center participation, which will be easier to do via RISE in the upcoming year.
Vanessa Caceres is a medical writer in Bradenton, Fla.
