Change is inevitable in healthcare. Often, it feels overwhelming—but occasionally, a new shift arrives that genuinely makes things simpler. The upcoming CMS shift toward the MIPS Value Pathways (MVPs) represents precisely that kind of beneficial change.
As someone who has navigated the complexities of the medical industry, I’ve learned how crucial it is to separate temporary trends from genuinely important transformations. The MVP model is much more than a passing trend—it is shaping up to be the future of Medicare reporting. The good news? Providers who take the time to understand and align with MVPs early will find themselves at a significant advantage.
Understanding MVPs Clearly and Simply
Think of MIPS Value Pathways (MVPs) like earning exercise badges on your Fitbit. When you use a Fitbit, each badge is tied to specific activities—such as running, cycling, or walking a certain number of steps. Similarly, MVPs group related performance measures into focused sets known as "care themes," making it easier for your practice to clearly demonstrate clinical strengths without getting lost in disconnected reporting requirements.
Just like how Fitbit clearly shows the fitness goals you've achieved, MVPs allow practices to clearly and simply demonstrate the quality and outcomes of their patient care.
CMS has identified several distinct care themes or pathways for MVP reporting, such as Managing Chronic Conditions, Optimizing Chronic Disease Prevention, Promoting Wellness and Preventive Care, Advancing Care for Heart Disease, Improving Care for Musculoskeletal Conditions, Enhancing Care for Diabetes, and Strengthening Mental and Behavioral Health Care.
This clear structure makes it easy to select the appropriate pathway based on your clinical strengths, and it simplifies reporting, making your life—and your team's—easier.
The Emotional and Practical Impact of MVPs
We all went into healthcare because we care deeply about people, not because we wanted to spend our days tangled up in paperwork. But somewhere along the way, administrative burdens began overshadowing the care itself. The MVP model aims to simplify reporting and bring focus back to patient care.
This shift isn't just operational—it has significant emotional and financial impacts. By aligning your reporting with meaningful clinical themes, you reclaim time and energy to focus on why you entered healthcare: improving people's lives. Additionally, clear alignment with MVP measures positions your practice well financially, as CMS increasingly ties payments to performance measures.
RPM, RTM, CCM, and APCM—How These Fit with MVPs
Many practices already use programs like Remote Patient Monitoring (RPM), Remote Therapeutic Monitoring (RTM), Chronic Care Management (CCM), or Advanced Primary Care Management (APCM). Each of these naturally aligns with specific MVP pathways.
RPM, for example, directly supports chronic disease management by continuously capturing important physiologic patient data, such as blood pressure or glucose levels. This fits seamlessly within the MVP pathway for managing chronic conditions. In fact, Medicare’s use of RPM increased more than tenfold between 2019 and 2022, reflecting its growing importance in Medicare’s approach to chronic care management according to a recent OIG report.
Similarly, RTM captures patient adherence to therapies and is particularly beneficial for MVP pathways related to musculoskeletal, respiratory, or behavioral health conditions. It fills a crucial gap by measuring patient engagement beyond clinical visits.
CCM has historically served as the foundation for chronic care. However, its administrative complexity and time-tracking requirements have become increasingly challenging for many practices, prompting a shift toward simpler, more integrated models like APCM.
APCM, by contrast, streamlines multiple care management services into fewer, complexity-based billing codes. This reduces complexity and aligns directly with MVPs' streamlined reporting philosophy.
The Importance of Early Adoption—Why Your Practice Should Move Now
CMS has indicated MVP participation will become mandatory by 2026. Early adopters who start aligning their practices with MVPs today gain significant advantages. Early preparation reduces the stress of last-minute changes, provides time for performance optimization, and positions your practice to maximize financial reimbursements from Medicare.
What Your Practice Can Do Today
If you're uncertain where to start, the first step is to evaluate your current care management programs. Determine how your current RPM, RTM, CCM, or APCM efforts align with CMS's outlined MVP themes. From there, educating your team about MVP reporting requirements will help ensure smooth implementation.
Consider integrating RPM and APCM more deeply into your clinical workflows, as these naturally produce ongoing, valuable patient data, making reporting straightforward. Finally, even before MVP reporting becomes mandatory, start voluntarily tracking MVP-aligned metrics internally. This early tracking builds familiarity and helps identify areas of strength and opportunities for improvement well ahead of mandated reporting deadlines.
Get In The Game
Just as Fitbit badges clearly showcase your fitness achievements, MVP reporting will highlight your clinical successes clearly and simply. It's a significant shift designed to emphasize value-based care, streamline reporting, and reduce administrative burdens.
Change in healthcare is constant, but meaningful change is rare. MVPs are meaningful because they reward the impactful, patient-focused care your practice already delivers. Practices that move proactively won't just survive this shift—they'll thrive because of it.
If navigating this transition feels overwhelming, you don't have to tackle it alone. My team and I specialize in simplifying these complexities, streamlining your operations, and positioning your practice to succeed in Medicare’s evolving landscape.
By being proactive now, you ensure your practice isn't just prepared—you ensure you're positioned to lead.