MIPS 2024: Approved and Unapproved Policies in the Final Rule

Gear up, providers! CMS has just released the MIPS 2024 final rule. CMS has provided the proposed rule before finalizing the policies for PY 2024 reporting. The clinicians need to be extra vigilant this time, as we notice that CMS is in full form. In CY 2024, it has already set the performance criteria and scoring standards. Now, it’s truly the clinicians’ responsibility to take part in the healthcare improvement battle with full spirit.

Although the proposed rule for MIPS 2024 has already informed clinicians about changes in MIPS. So, clinicians have a rough idea of the rules and resultant situations coming their way. So, clinicians start the PY 2024 with an entire focus on their motives. Now, before further delay, let’s discuss the MIPS factsheet.

MIPS 2024: Coming Back to its Original Track

The MIPS program was working well under the Quality Payment Program of CMS. With every successive performance year, the federal government was making constructive changes. There were lots of reasons behind the rule modifications every year. The implementation of value-based care in a wide healthcare system was one motive. However, there are several other parameters behind this key motive that still require attention. And CMS wanted to address them all progressively.

Anyhow, a public health emergency in the form of COVID-19 damaged the overall system. Healthcare providers were working day and night to provide the ultimate patient care to everyone. CMS has therefore given some relaxations to providers who have already been stressed by PHE.

Right now, the healthcare industry has overcome the COVID crisis. So, CMS has decided to move back to the original track of MIPS reporting in CY 2024. Thereby, the PFS final rule includes policies that shed light on continuity. Also, the MIPS final rule supports digital measurement and interoperability. Along with this, CMS is more focused on the development of MIPS Value Pathways (MVPs).

Highlights of Policies Approved for MIPS 2024

Here we have listed some of the major policies approved for MIPS reporting in the final rule. Have a glance at them!

New MVPs and Modification

MIPS value pathways were a voluntary reporting option in MIPS 2023. However, MVPs are introduced to accomplish future goals. The MIPS 2024 final rule has five new MVPs on the list for healthcare providers. Apart from this, some MVPs have certain modifications. Overall, we have 16 MVPs available (finalized) for PY 2024 reporting.

New

Modified

● Rehabilitative Support for Musculoskeletal Care

● Quality Care for the Treatment of Ear, Nose, and Throat Disorders

● Quality Care in Mental Health and Substance Use Disorders

● Prevention and Treatment of Infectious Disorders, Including Hepatitis C and HIV

● Focusing on Women’s Health

● Improving Lower Extremity Joint Repair Care

● Suitability for Individuals with Intermittent Neurological Disorders

● Neurodegenerative Disease Supportive Care

● Adopting Best Practices in Emergency Medicine and Promoting Patient Safety

● Improving Oncology Care

● Cardiovascular Disease Care Advancement

● Rheumatology Patient Care Advancement

● Stroke Care Coordination to Promote Prevention and Positive Outcomes

● Kidney Health Care at Its Finest

● Patient safety and encouragement of positive anesthesia experiences

● Primary Care Value

Performance Period for the PI Performance Category

For this category of MIPS reporting, clinicians will get a 180-day performance period. The policy change perfectly aligns with the CMS’s plan for growth and the Medicare PI Program.

Medicare CQMs for ACOs

CMS has given the green light to the collection of Medicare Clinical Quality Measures (CQMs) for ACOs participating in the MSSP, specifically under the Medicare CQMs collection type. This applies to ACOs that meet reporting requirements within the APM Performance Pathway (APP) of the Shared Savings Program.

Highlights of Policies Not Finalized for MIPS 2024

Now, let’s see which policies CMS has not approved and are still pending.

Increase in Performance Threshold

During the rulemaking period, everyone was expecting changes in the performance threshold. Expecting this change was not new as CMS has done this before. The proposed final rule presented this idea. However, in the PY 2024 final rule, there is no such change. The performance threshold for MIPS reporting is still 75 points. Clinicians will get penalties for scoring below this.

Increase in Data Completeness

No change has been made to the data completeness requirement so far. Also, the decision to increase the data completeness threshold for 2027 is still pending.

Qualifying APM Participant (QP) determinations

Last but not least, CMS is very clear about the QP determinations. CMS has made these determinations at the APM entity level in the past. And the same is going to be done in FY 2024. No such policy of QP determination at the individual clinician level has been finalized yet.

Conclusion

That’s all about the MIPS 2024 final rule. We hope this fact sheet will be helpful for your MIPS reporting in the year ahead. Revise your reporting strategies and ask for help from MIPS qualified registries like us for a fine plan. With our MIPS consulting services, you can work on your deficiencies and improve your performance in MIPS.