Posted by Karen Grace Larsen
The final rule for the 2025 Medicare Physician Fee Schedule is officially out, setting the stage for the Merit-Based Incentive Payment System (MIPS) in the upcoming performance year.
The release not only brings to light essential updates and policies by the Centers for Medicare & Medicaid Services (CMS); it also underscores the importance of preparing early to navigate the complexities of MIPS compliance in 2025.
For healthcare practices like yours, early MIPS preparation is critical. It allows you to adapt to changes, fine-tune strategies, and maximize your chances of MIPS success.
But how do you do that? And where do you start?
MIPS in 2025: Major Changes Your Practice Needs to Know
Understanding the latest MIPS updates marks your starting line for the 2025 performance year. Doing so allows you to clearly see which changes have the potential to affect how your practice operates, reports data, and receives incentives under the Quality Payment Program (QPP).
Here are important MIPS updates you need to know about, as outlined by CMS:
MIPS Value Pathways
MIPS Value Pathways (MVPs) are an alternative reporting option to meet your MIPS reporting requirements. They provide clinicians with a more streamlined and clinically relevant reporting approach, organizing related measures and activities around providers’ specialty or public health priorities.
The final rule adds six new MVPs to the inventory, targeting the following specialties:
- Ophthalmology
- Dermatology
- Gastroenterology
- Pulmonology
- Urology
- Surgical Care
While MVP reporting remains voluntary in 2025, CMS is preparing for a gradual transition from traditional MIPS to MVPs.
Quality Performance
To count as valid, Quality Performance category submissions must include all required numerator and denominator data for at least one MIPS quality measure. CMS will not score incomplete data submissions. This change aims to reduce the negative impacts of invalid entries.
For clinicians submitting data through multiple channels, CMS will calculate and apply the highest score among submissions. If your organization has multiple submissions, CMS will score the most recent ones, which override previous submissions of the same type.
Improvement Activities
For the 2025 performance period, the total number of Improvement Activities has decreased from 106 to 104. Here are the updates in the final rule:
- New Activities
- Implementation of Protocols and Provision of Resources to Increase Lung Cancer Screening Uptake
- Save a Million Hearts: Standardization of Approach to Screening and Treatment for Cardiovascular Disease Risk
- Modified Activity
- Population Health
- Removed Activities
- Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record
- Implementation of a Personal Protective Equipment Plan
- Implementation of a Laboratory Preparedness Plan
- Invasive Procedure or Surgery Anticoagulation Medication Management
Promoting Interoperability
While the final rule doesn’t make significant changes to the Promoting Interoperability category, it does end automatic reweighting for clinical social workers. Beginning in the 2025 performance year, reweighting will apply only to clinicians, groups, and virtual groups with special statuses.
The final rule tightened data requirements for Promoting Interoperability submissions to dampen the negative impacts of invalid and incomplete entries. To count as valid, submissions must include performance data, required attestations, a CMS Electronic Health Record (EHR) Certification ID, and performance period dates.
Telehealth Policies
The continuation of expanded telehealth coverage depends on Congressional action. Without intervention, telehealth policies will revert to pre-COVID-19 standards by the end of 2024.
This means that in 2025, Medicare-covered telehealth services will be limited to sessions conducted in originating sites—specific healthcare facilities located in designated rural areas. However, some services may still qualify under established exceptions:
- Mental health services meeting specific criteria
- Specific chronic care management programs
- Specific services on the permanent Medicare Telehealth Services List
MIPS Best Practices for a Successful Performance Year
The latest changes reflect CMS's ongoing efforts to streamline MIPS reporting, emphasize health equity, and transition towards more specialized care pathways.
To achieve MIPS success (and avoid penalties) in 2025, healthcare practices must align their operations and reporting strategies with the latest requirements. Here are five ways to set your practice up for success in the upcoming year:
1. Set Clear Goals for Each Performance Category
Establishing specific and measurable objectives for each category is a good way to ensure MIPS success. Identify your practice's strengths and prioritize categories that yield the most points.
- Quality: Focus on outcome-based measures relevant to your practice specialty.
- Cost: Analyze your claims data to identify and address high-cost areas in your practice.
- Improvement Activities: Select activities that align with your practice’s goals and are worth the maximum points.
- Promoting Interoperability: Ensure your practice meets electronic exchange requirements, like e-prescribing and patient portal use.
2. Leverage Historical Practice Data
Past MIPS performance data is an invaluable tool for shaping your 2025 strategy. Reviewing previous performance reports can help you identify gaps and underperforming areas.
It can also help you highlight measures where you consistently excel, allowing you to focus on scoring higher in those areas. If, for example, you’ve noticed that your practice historically struggles with MIPS documentation, you may want to prioritize ambient scribing technology in 2025.
Meditab simplifies this process by equipping its flagship EHR system, IMS, with a robust practice analytics feature that gives you access to valuable data from every aspect of your practice. With in-depth analytics and real-time progress tracking, IMS helps you identify which measures to focus on for the highest returns.
3. Streamline Your Data Collection Processes
Accurate and timely data collection is the backbone of MIPS compliance. This is because your performance depends on the quality and completeness of the data you report. If you want to optimize MIPS data collection in your practice, embracing automation is the way to go.
Manual data entry can lead to errors, inefficiencies, and missed opportunities. Invest in tools and systems that collect and organize data for you.
For example, established EHR solutions such as IMS can automate the collection of relevant data, such as tracking patient visits, capturing quality measures, and recording improvement activities. Equipped with an entire module dedicated to MIPS reporting, IMS can also streamline clinical workflows and ensure your data is ready for submission.
4. Entrust MIPS Oversight to a Trusted Member
Assigning responsibilities ensures accountability and fosters teamwork. Designate a MIPS coordinator to oversee compliance efforts, including:
- Data collection and submission
- Staff education and training on MIPS requirements
- Regular updates to practice workflows to meet new regulatory demands
If your team lacks the bandwidth or expertise to hire a dedicated MIPS coordinator, you can partner with Meditab’s QPP team for expert guidance, comprehensive staff training, and round-the-clock MIPS support.
5. Tap into Your EHR’s Full Potential
Your EHR is a powerful ally in MIPS preparation. Advanced systems like Meditab’s IMS include a robust module that offers specific EHR features for MIPS:
- Dedicated MIPS Dashboard: Gain clear insights into your MIPS performance with an intuitive dashboard that tracks progress against benchmarks year-round, automatically capturing and presenting key data for each measure.
- Automated MIPS Reports: Eliminate manual tracking errors and ensure timely submissions! Updated yearly, IMS’s MIPS report template allows you to conveniently check your compliance status, current scores, and provider performance.
Innovative Integrations: Our QPP team can set up, map, and customize your IMS to automate your compliance process. This allows you to leverage integrations such as e-prescribing, clinical data exchange, and patient engagement tools, making it easier to meet multiple category requirements.
Kickstart Your MIPS Yearly Preparation with Meditab
The road to MIPS success begins with early preparation, strategic planning, and the right technology.
It’s no easy feat, but Meditab’s comprehensive MIPS services and user-friendly EHR solutions make the journey more straightforward than ever. With our innovative tools and expert QPP support, you can approach MIPS compliance with confidence and clarity.
Navigate MIPS compliance, avoid costly penalties, and maximize incentives—all while enhancing patient outcomes. Meditab is committed to equipping your practice with the tools and expertise you need to thrive in value-based care.
