Planning for MIPS Changes

Written By Chirpy Bird contributor Shereese Maynard, MS, MBA She/Her

The November 1, 2024 CMS announcement brings significant updates to MIPS for the coming year. Here are the five most important changes impacting your practice in 2025.

1. Stability in Core Requirements Provides Planning Opportunity

The performance threshold stays at 75 points for 2025, while data completeness remains at 75% through 2028. This stability gives practices a clear target for success. To maximize your score:

• Review your 2024 performance data now to identify improvement areas
• Focus on measures where you consistently score above the 75th percentile
• Document your quality actions thoroughly to meet the 75% completeness requirement

2. Quality Measure Portfolio Gets a Major Update

CMS has revamped the quality measures for 2025, offering 195 options, including seven new ones. More interesting is the removal of 10 measures and substantial changes to 66 existing ones. Smart strategy tips:

• Evaluate the seven new measures to see if they align better with your practice
• If you're using any of the 66 modified measures, review the changes early
• Consider switching to Medicare CQMs, which now offer a 2-year flat benchmark for more predictable scoring

3. Specialty-Specific Pathways Expand

Adding six new MIPS Value Pathways (MVPs) opens doors for specialists. New pathways cover:

• Ophthalmology
• Dermatology
• Gastroenterology
• Pulmonology
• Urology
• Surgical care

If your specialty is listed above, switching to the relevant MVP could streamline reporting and potentially boost your score through more relevant measures.

4. Alternative Payment Models Offer New Opportunities

The new APM Performance Pathway (APP) Plus quality measure set provides another option for practices ready to move beyond traditional MIPS. Consider this pathway if:

• Your practice has strong quality metrics
• You're comfortable with value-based care models
• You have the infrastructure to track and report more complex measures

For larger organizations, the new Complex Organization Adjustment for ACOs might make joining an ACO more attractive than standard MIPS participation.

5. Strategic Changes to Improvement Activities

CMS has streamlined the Improvement Activities (IA) requirements while modifying cost measures. To adapt:

• Review the new qualifying data submission minimums
• Evaluate whether the eCQM incentive extension benefits your practice
• Consider how the modified cost measures might impact your total score

Here's the thing . . .,

The 2025 MIPS program offers both stability and new opportunities. Small practices benefit most from focusing on the consistent performance threshold and data completeness requirements. Specialists should seriously consider moving to the new MVPs. Larger groups may want to explore the APP Plus pathway or participate in ACO.

Remember: The key to MIPS success isn't just meeting minimums—it's about choosing the pathway that best aligns with your practice's strengths and capabilities.

Need help deciding which pathway is right for your practice? Contact the team at Chirpybirdinc.com for a personalized assessment.