2025 MIPS Value Pathways: What You Need to Know
New value pathways and interoperability changes reflect an emphasis on streamlining healthcare management
The Centers for Medicare & Medicaid Services (CMS) revealed some updates to its MIPS Value Pathways (MVPs) program as part of their finalized rules for 2025. The program launched in 2023 and was designed to help un-silo and build alignment across performance category scores and reporting. As a result, the overall MVPs process may become less burdensome to manage and more relevant to specialty providers than initial MIPS processes and may support improved patient outcomes at lower costs.
Are MIPS Value Pathways required?
Although MVP participation is optional at this time, it’s important to familiarize yourself with it. CMS plans to sunset traditional MIPS in the coming years, eventually making MVP reporting mandatory.
Once the transition to MVPs is complete, practices may experience another significant shift in how they collect, track and report their performance data. CMS recommends early adoption of MVP reporting so this future change doesn’t cause disruptions to your practice workflow.
How to report for MVPs
If you choose to report for an MVP, you will be required to register with CMS. MVP registration is slated to open in April 2025, but be sure to keep an eye on the CMS website for official registration deadlines.
Reporting requirements include the same four performance categories that MIPS has always included, plus a foundational layer of promoting interoperability and population health measures.
With MVPs, you’ll likely have fewer measures to report, and many are designed with a specific specialty or medical condition in mind. For example, orthopedic providers who report to the Improving Care for Lower Extremity Joint Repair MVP must attest to four of the eight available quality measures (at least one must be an outcome measure) and at least one of 13 improvement activity (IA) measures. CMS uses administrative claims data to calculate performance in the Cost category, and starting with the 2025 performance year, CMS will calculate all available population health measures for an MVP participant and apply the highest scoring measure to their Quality category score.
Read on to get an overview of how MVPs may impact your practice and how you can prepare for the future of value-based care today.
What are MIPS Value Pathways?
MIPS Value Pathways (MVPs) are an updated set of measures and activities that physicians and clinics can follow to satisfy MIPS reporting requirements.
Here is some key information regarding the MVPs program:
- The four MIPS performance categories are the same for MVPs — Quality, Cost, Promoting Interoperability and Improvement Activities.
- Quality, cost and improvement activity measures are scored at the MVP level, meaning your practice would choose measures from a CMS list related to your value pathway.
- The Promoting Interoperability category is specialty-agnostic.
- Population health measures are also part of a foundational, specialty-agnostic layer. For the 2025 reporting year, MVP participants are no longer required to choose a population health measure at registration, and CMS will assign the highest-scoring population health measure available for each MVP participant.
- Multi-specialty groups may divide into subgroups, submitting population health and interoperability data at the group level and quality, cost and improvement activity data at the subgroup level
These changes are intended to contribute to a larger evolution in approach. Under MVPs, quality measures must be reported in relation to cost and improvement measures. This is designed to help ensure scoring represents a meaningful and cohesive picture of a clinic’s performance.
The evolution of MIPS Values
MIPS was created to help shift incentives away from fee-for-service payment models and toward higher-quality care at a lower cost.
Within the MVP framework, CMS intends to create tighter alignment between measures and activities for different specialties or conditions. By considering population health and interoperability as foundational to the evolution of healthcare, MVPs may be able to promote the objectives of the industry as a whole while ensuring the differences in specialty-specific care don’t slip through the cracks.
The inclusion of technology solutions to achieve these ends helps build visibility and efficiencies in cost and care. The focus on specialty-specific priorities and workflows within our EMA® EHR and gGastro® EHR can further these efficiencies:
- Centralized patient records make it easier for patients, providers and third-party partners to access data when they need it.
- Purpose-built workflows may speed up documentation with fewer clicks and taps for providers, helping to support accuracy and return physician focus to the patient.
- Automation helps perform many downstream tasks and helps to promote consistency of data across workflows.
Practices that optimize solutions may also experience other benefits, like improved patient engagement, reduction of administrative burdens on clinic staff, and attracting new providers to support growth.
New Value Pathways
For the 2025 performance year, CMS has added six new MVPs and modified existing MVPs.
New MVPs
- Complete Ophthalmological Care
- Dermatological Care
- Gastroenterology Care
- Optimal Care for Patients with Urologic Conditions
- Pulmonary Care
- Surgical Care
In the 2025 performance period, ModMed plans to support the orthopedic and dermatological MVP measures within our EMA EHR. As additional measures are finalized, our teams will assess them and make them available in our EMA and gGastro EHRs, when appropriate.
Modified MVPs
- Adopting Best Practices and Promoting Patient Safety within Emergency Medicine
- Advancing Cancer Care
- Advancing Care for Heart Disease
- Advancing Rheumatology Patient Care
- Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes
- Focusing on Women’s Health
- Improving Care for Lower Extremity Joint Repair
- Optimal Care for Kidney Health
- Patient Safety and Support of Positive Experiences with Anesthesia
- Prevention and Treatment of Infectious Disorders Including Hepatitis C and HIV
- Quality Care for Patients with Neurological Conditions (consolidation of Optimal Care for Patients with Episodic Neurological Conditions and the Supportive Care for Neurodegenerative Conditions MVPs)
- Quality Care for the Treatment of Ear, Nose, and Throat Disorders
- Quality Care in Mental Health and Substance Use Disorders
- Rehabilitative Support for Musculoskeletal Care
- Value in Primary Care MVP
If you’re interested in helping CMS shape the future state of MIPS, they have also created guidelines to develop candidates for new value pathways. These guidelines mirror the components of current MVPs.
Quality performance category
CMS has issued the following important changes to the Quality category for the 2025 performance year:
- MVP participants are no longer required to select a population health measure during registration.
- CMS will calculate all available population health measures for an MVP participant and apply the highest-scoring one to their Quality category score.
Improvement Activities performance category
1. Activity weighting eliminated
Starting in the 2025 performance year, improvement activities are no longer categorized as high- or medium-weighted activities. All activities are now worth equal point values.
2. Reduced activity requirements
MVP participants are now required to attest to only one improvement activity.
Promoting Interoperability performance category
There are no updates for the Promoting Interoperability (PI) category for the 2025 calendar year. You must submit the same PI measures required under traditional MIPS, unless you qualify for reweighting of the PI category.
Since CMS requires a 180-day minimum PI performance period, the final day you can begin your 2025 PI performance period will be July 5, 2025.
Cost performance category
CMS calculates performance exclusively on the cost measures included in the MVP using administrative claims data.
Preparing for MIPS Value Pathways
Physicians who underwent the transition to MIPS processes may recognize the value of preparing for MVPs now. Any change in rules and reporting may present a challenge to your business and its bottom line. With advanced preparation, you may be able to mitigate the risks of transitioning to new value pathways and maintain continuity in your practice’s day-to-day operations.
If you need additional MIPS support, we encourage our clients to take advantage of our MIPS advising. With our MIPS Advisory Services for EMA and gGastro clients, you’ll get a MIPS advisor who knows both your EHR and your practice. They’ll monitor your performance and work with you to achieve your goals.
Plus, we offer additional MIPS resources, such as webinars and guides, as well as helpful articles for current ModMed clients in our ModMed Communities platform.
Need help with MIPS? Check out our solutions for EMA and gGastro clients.
This blog is intended for informational purposes only and does not constitute legal or medical advice. Please consult with your legal counsel and other qualified advisors to ensure compliance with applicable laws, regulations and standards.
