MIPS Value Pathways (MVPs)

MIPS Value Pathways (MVPs) (2024)

Merit-based Incentive Payment System Value Pathways (MVPs) are a subset of measures and activities, established through rulemaking, that can be used to meet MIPS reporting requirements. 

Those choosing to report MVPs will be able to report their data through AQI NACOR's Qualified Registry (MIPS measures only) or Qualified Clinical Data Registry (QCDR) options (MIPS and QCDR measures may be reported). Please check the MVP specifications carefully as CMS has changed, from 2023, the available quality measures and improvement activities for 2024. 

The MVP framework aims to align and connect measures and activities across the quality, cost, and improvement activities performance categories of MIPS for different specialties or conditions. In addition, the MVP framework incorporates a foundation that leverages Promoting Interoperability measures and a set of administrative claims-based quality measures that focus on population health in order to reduce reporting burden.

For Performance Year 2024, CMS approved a revised "Patient Safety and Support of Positive Experiences with Anesthesia MVP." MVP scoring and special status designations do not differ from Traditional MIPS policies. Those groups choosing to report the MVP in 2024 will only need to report four quality measures, 1 high-weighted or 2 medium weighted improvement activities (or one Patient Centered Medical Home Improvement Activity) and promoting interoperability measures (optional depending on your special status designation). CMS will calculate the Medicare Spending Per Beneficiary (MSPB) Clinician measure for the Cost Performance Category.

In 2024, eligible clinicians and their groups will need to choose four measures from this designated list:

• Q404: Anesthesiology Smoking Abstinence
• Q424: Perioperative Temperature Management
• Q430: Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy
• Q463: Prevention of Post-Operative Vomiting (POV) - Combination Therapy (Pediatrics)
• Q477: Multimodal Pain Management
• Q487: Screening for Social Drivers of Health 
• AQI48: Patient-Reported Experience with Anesthesia
• ABG44: Low Flow Inhalational General Anesthesia
• ePreop31: Intraoperative Hypotension (IOH) Among Non-Emergent Noncardiac Surgical Cases

Eligible clinicians and their groups also have a set of twelve (12) improvement activities to choose:

• IA_BE_6: Regularly Assess Patient Experience of Care and Follow Up on Findings (High)
• IA_BE_22: Improved practices that engage patients pre-visit (Medium)
• IA_BMH_2: Tobacco use (Medium)
• IA_CC_2: Implementation of improvements that contribute to more timely communication of test results (Medium)
• IA_CC_15: PSH Care Coordination (High)
• IA_CC_19: Tracking of clinician’s relationship to and responsibility for a patient by reporting MACRA patient relationship codes (High)
• IA_EPA_1: Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient’s Medical Records (High)
• IA_MVP: Practice-Wide Quality Improvement in MIPS Value Pathways
• IA_PCMH: Electronic submission of Patient Centered Medical Home accreditation. 
• IA_PSPA_1: Participation in an AHRQ-listed patient safety organization (Medium)
• IA_PSPA_7: Use of QCDR data for ongoing practice assessment and improvements (Medium)
• IA_PSPA_16: Use of decision support and standardized treatment protocols (Medium)

MVP Registration (2024)

In April of 2024, CMS will released details on MVP registration via its QPP Resource Library. The documents will include a registration form and process information. The deadline for registration is likely to be November 30, 2024.

At the time of registration, individuals and groups:

• Must identify the population health measure the MVP participant wishes to be evaluated on. If the MVP participant doesn’t meet case minimum for the population health measure selected during registration, CMS will attempt to evaluate the MVP participant on the other population health measure. If the MVP participant doesn’t meet case minimum for either population health measures, the measure will be excluded from scoring.

• Must, if the MVP includes an outcomes-based administrative claims measure, indicate whether the MVP participant would like to be evaluated on it as 1 of their 4 required quality measures. If the MVP participant doesn’t meet case minimum for the outcomes-based administrative claims measure, they’ll receive 0 out of 10 points for the required outcome measure unless they submit another outcome measure.

Even if you register to report an MVP, you can still choose to report traditional MIPS or the APM Performance Pathway (APP), if applicable.

Subgroup Reporting (2024)

CMS defines a subgroup as, “A subset of a group which contains at least one MIPS eligible clinicians and is identified by a combination of the group Taxpayer Identification Number (TIN), the subgroup identifier, and each eligible clinician’s National Provider Identifier (NPI).” Anesthesiologists who participate in MIPS with non-anesthesiologists may be able to report the anesthesia MVP. Please check with your group administrator or CMS for eligibility requirements.

What are the differences between Traditional MIPS and MVPs (2023 and 2024)?

Anesthesiologists and their groups may report either Traditional MIPS or the Anesthesia MVP in 2023. The table below includes some considerations when choosing whether to report one or the other.

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MIPS Value Pathways (2023)

The Centers for Medicare & Medicaid Services (CMS) first implemented the Merit-based Incentive Payment System Value Pathway (MVP) in 2023. MVPs are a subset of measures and activities, established through rulemaking, that can be used to meet MIPS reporting requirements.

Those choosing to report MVPs will be able to report their data through AQI NACOR's Qualified Registry (MIPS measures only) or Qualified Clinical Data Registry (QCDR) options (MIPS and QCDR measures may be reported).

For Performance Year 2023, CMS approved the "Patient Safety and Support of Positive Experiences with Anesthesia MVP." MVP scoring and special status designations do not differ from Traditional MIPS policies. Those groups choosing to report the MVP in 2023 will only need to report four quality measures, 1 high-weighted or 2 medium weighted improvement activities (or one Patient Centered Medical Home Improvement Activity) and promoting interoperability measures (optional depending on your special status designation). CMS will calculate the Medicare Spending Per Beneficiary (MSPB) Clinician measure for the Cost Performance Category.

Eligible clinicians and their groups will need to choose four measures from this designated list:

• Q404: Anesthesiology Smoking Abstinence
• Q424: Perioperative Temperature Management
• Q430: Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy
• Q463: Prevention of Post-Operative Vomiting (POV) - Combination Therapy (Pediatrics)
• Q477: Multimodal Pain Management
• AQI48: Patient-Reported Experience with Anesthesia
• AQI69: Intraoperative Antibiotic Redosing.

Eligible clinicians and their groups also have a set of eleven (11) improvement activities to choose:

• IA_BE_6: Regularly Assess Patient Experience of Care and Follow Up on Findings (High)
• IA_BE_22: Improved practices that engage patients pre-visit (Medium)
• IA_BMH_2: Tobacco use (Medium)
• IA_CC_2: Implementation of improvements that contribute to more timely communication of test results (Medium)
• IA_CC_15: PSH Care Coordination (High)
• IA_CC_19: Tracking of clinician’s relationship to and responsibility for a patient by reporting MACRA patient relationship codes (High)
• IA_EPA_1: Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient’s Medical Records (High)
• IA_PCMH: Electronic submission of Patient Centered Medical Home accreditation.
• IA_PSPA_1: Participation in an AHRQ-listed patient safety organization (Medium)
• IA_PSPA_7: Use of QCDR data for ongoing practice assessment and improvements (Medium)
• IA_PSPA_16: Use of decision support and standardized treatment protocols (Medium)

Registration Process

Individuals and groups must register with CMS during the 2023 performance period to report an MVP. The 2023 registration period closed on November 30, 2023. Even if you register to report an MVP, you can still choose to report traditional MIPS or the APM Performance Pathway (APP), if applicable.

For more information on registration, please contact CMS at [email protected].

For more information, please contact ASA Department of Quality and Regulatory Affairs at [email protected].