MIPS 2024: Final Rule Released!

Streamlining MIPS: A Glimpse into the Future of Value-Based Care

The Medicare Physician Fee Schedule (PFS) for the calendar year 2024 has introduced some pivotal changes that are set to refine the MIPS program. With a strategic vision aimed at promoting equitable, safe, and high-value patient care, the proposed rule brings forth updates that could significantly impact how healthcare providers approach value-based care.

Key Updates to MIPS for 2024

1. Quality Measure Adjustments: The proposal includes updates to the Quality measure section, with certain measures proposed for removal due to the end of their topped-out lifecycle. For instance, measures like the Age-Related Macular Degeneration (AMD): Dilated Macular Examination and Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use are on the list for removal, signaling a shift towards more relevant and impactful measures.

2. Focus on Mental Health: A new Patient-Reported Outcome-based Performance Measure (PRO-PM) is proposed, emphasizing the reduction in suicidal ideation or behavior symptoms. This measure underscores CMS's priority on mental health and substance use disorders, reflecting a broader commitment to addressing these critical areas.

3. Enhanced Patient Engagement: The proposed rule encourages practices to engage patients and families by sharing quality of care, patient experience, and utilization data. This transparency is a step towards fostering a collaborative environment where patients are active participants in their healthcare journey.

4. Refinement of Improvement Activities: Certain improvement activities are suggested for removal, such as the Implementation of co-location PCP and MH services, to streamline the program and focus on activities that drive significant improvements in care delivery.

5. Connecting Patients to Community Services: A new measure is proposed to track the percentage of patients with health-related social needs who had contact with a Community Service Provider within 60 days after screening. This measure aims to bridge the gap between clinical care and social services, addressing social determinants of health.

Scoring Requirements and Reporting Rate Increases

To avoid penalties, providers must be aware of the following scoring requirements and reporting rate increases:

- Data Completeness Thresholds: For eCQMs, MIPS CQMs, Medicare Part B claims measures, and QCDR measures, the data completeness thresholds are proposed to be 75% for the 2026 performance period and 80% for the 2027 performance period.

- Performance Threshold: The performance threshold is set at 75 points for the 2023 MIPS performance period/2025 MIPS payment year, with a proposed increase to 82 points for the 2024 MIPS performance period/2026 MIPS payment year.

Implications for Providers

These proposed changes reflect a commitment to continuous improvement and innovation within the MIPS program. Providers should anticipate adjustments in their reporting and performance strategies, particularly with the increased focus on mental health and social determinants of health.

Reaching out to Premier MIPS Consulting today to discuss your MIPS 2024 strategy ASAP!