MIPS 2025: Key Changes and What They Mean for Healthcare Providers

As we approach 2025, the Merit-based Incentive Payment System (MIPS) continues to evolve, introducing new challenges and opportunities for healthcare providers. The latest updates bring significant changes across various performance categories, including quality measures, cost measures, and improvement activities. Here’s an overview of the key updates.

Threshold and Data Completeness

To avoid a negative payment adjustment in 2025, providers must achieve a MIPS score of at least 75%. Additionally, data completeness remains a priority, requiring 75% of eligible patients to have proper documentation and submission.

Quality Measure Updates

MIPS 2025 introduces:

• Seven new quality measures
• Retirement of ten existing measures
• Significant changes to 66 existing measures, reflecting ongoing refinement efforts

Improvement Activities

The improvement activities category sees the following changes:

• Addition of two new activities focusing on lung cancer screening and cardiovascular disease risk screening
• Removal of four existing activities
• Modification of one activity to include broader vaccine achievement goals

Promoting Interoperability

The promoting interoperability category continues with a 180-day data collection period. Key updates include:

• Removal of automatic reweighting for clinical social workers
• Updates to objectives and measures such as electronic prescribing and health information exchange

MIPS Value Pathways (MVPs)

Key changes to the MVP framework include:

• Combining two neurology-focused MVPs into one
• Adding six new MVPs
• Expanding the framework to cover approximately 80% of specialties
• Updating population health measure scoring to use the highest available score

Specialty Measure Sets

Updates to specialty measure sets aim to provide a more accurate reflection of performance by:

• Eliminating the 7-point cap for certain measures
• Developing new MVPs to address multiple specialty measure sets

Conclusion

The MIPS 2025 updates reflect a commitment to improving care quality while reducing the reporting burden on providers. Staying informed and adapting to these changes will help healthcare providers meet requirements and maintain high standards of care.