Traditional MIPS vs. MIPS Value Pathways: All You Need To Know

 MIPS reporting has changed considerably in recent years. The Merit-based Incentive Payment System has always required clinicians to report across quality, cost, improvement activities, and promoting interoperability. The problem with the traditional structure was that it pulled from a broad measure library, and providers often ended up reporting on things that had little connection to their actual clinical work. MIPS Value Pathways were designed to address that. CMS introduced MVPs as a voluntary option starting with the 2023 performance year, and the broader intent is straightforward: traditional MIPS will eventually be replaced.

What Is Traditional MIPS

Traditional MIPS covers four performance categories:

• Quality
• Cost
• Improvement Activities
• Promoting Interoperability

Under traditional MIPS reporting, clinicians select from a large pool of measures across these categories. There is no requirement that the chosen measures connect to a specific specialty or condition. A cardiologist and a general practitioner could end up reporting on the same measures, even if those measures reflect very different clinical realities. That disconnect is what made the data less useful for both CMS and the clinicians themselves.

What Are MIPS Value Pathways

MIPS Value Pathways are a defined subset of measures and activities grouped around specific specialties, clinical conditions, or episodes of care. Rather than selecting from the full MIPS measure library, clinicians reporting through an MVP work within a pathway that reflects what they actually treat.

The MVP framework also incorporates a foundational layer that includes Promoting Interoperability measures and administrative claims-based quality measures focused on population health, which helps reduce overall reporting burden. 

There are currently 16 available MVP options covering a range of specialties and conditions, from rheumatology to anesthesia to chronic disease management.

Traditional MIPS vs. MVPs: Key Differences

Features	Traditional MIPS	MIPS Value Pathways
Measure selection	Broad, clinician's choice	Specialty or condition-specific
Reporting burden	Higher	Reduced
Subgroup reporting	Not available	Available
Population health layer	Not required	Built in
Future status	Being phased out	Becoming mandatory

The whole point of MVP reporting is to start measuring the performance of specialists within a practice who have, under traditional MIPS, been reporting on practice-wide measures largely irrelevant to their scope of work. 

Who Can Report MVPs

MVPs can be reported by individual MIPS eligible clinicians, single specialty groups, multispecialty groups, or APM Entities. MVPs can also be reported at the subgroup level, which is not an option under traditional MIPS. 

Registration is required. Clinicians must register with CMS as MVP participants within the designated window during the performance year. Choosing an MVP also means committing to the measures within that pathway for the full performance year.

What Scoring Looks Like Under MVPs

Scoring under MIPS Value Pathways largely mirrors traditional MIPS. Performance category weights remain consistent with traditional MIPS, and reweighting policies also align, with one exception: CMS will not reweight the Quality category if a score cannot be calculated because there is no applicable quality measure for the clinician. 

For the 2026 performance year, clinicians reporting an MVP will need to report four quality measures, one improvement activity, and promote interoperability measures, with CMS calculating the Medicare Spending Per Beneficiary measure for the Cost category. 

Where MIPS Reporting Is Headed

CMS has been clear about the direction. Traditional MIPS reporting is being phased out, with MVPs set to become the standard path forward unless clinicians are reporting through the APM Performance Pathway. The 2027 performance year has been referenced as the point after which traditional MIPS would no longer be an option. Practices that have not yet looked into MVPs will need to get familiar with the available pathways and what registration involves before that window closes.

Conclusion

The move from traditional MIPS to MIPS Value Pathways changes how performance gets measured, not just how it gets reported. Specialty-aligned measures give CMS more relevant data and give clinicians a clearer picture of how their work is being assessed. The transition is gradual for now, but the timeline is moving. Organizations that start understanding MVP requirements early will have more room to plan, rather than adjusting under pressure when reporting becomes mandatory.

Persivia offers various health management platforms that help healthcare organizations stay on top of quality program requirements, track performance across measures, and manage reporting without the manual work that typically slows teams down.

Traditional MIPS vs. MIPS Value Pathways: All You Need To Know

MIPS reporting has changed considerably in recent years. The Merit-based Incentive Payment System has always required clinicians to report across quality, cost, improvement activities, and promoting interoperability. The problem with the traditional structure was that it pulled from a broad measure library, and providers often ended up reporting on things that had little connection to their actual clinical work. MIPS Value Pathways were designed to address that. CMS introduced MVPs as a voluntary option starting with the 2023 performance year, and the broader intent is straightforward: traditional MIPS will eventually be replaced.

What Is Traditional MIPS

Traditional MIPS covers four performance categories:

• Quality
• Cost
• Improvement Activities
• Promoting Interoperability

Under traditional MIPS reporting, clinicians select from a large pool of measures across these categories. There is no requirement that the chosen measures connect to a specific specialty or condition. A cardiologist and a general practitioner could end up reporting on the same measures, even if those measures reflect very different clinical realities. That disconnect is what made the data less useful for both CMS and the clinicians themselves.

What Are MIPS Value Pathways

MIPS Value Pathways are a defined subset of measures and activities grouped around specific specialties, clinical conditions, or episodes of care. Rather than selecting from the full MIPS measure library, clinicians reporting through an MVP work within a pathway that reflects what they actually treat.

The MVP framework also incorporates a foundational layer that includes Promoting Interoperability measures and administrative claims-based quality measures focused on population health, which helps reduce overall reporting burden. 

There are currently 16 available MVP options covering a range of specialties and conditions, from rheumatology to anesthesia to chronic disease management.

Traditional MIPS vs. MVPs: Key Differences

Features	Traditional MIPS	MIPS Value Pathways
Measure selection	Broad, clinician's choice	Specialty or condition-specific
Reporting burden	Higher	Reduced
Subgroup reporting	Not available	Available
Population health layer	Not required	Built in
Future status	Being phased out	Becoming mandatory

The whole point of MVP reporting is to start measuring the performance of specialists within a practice who have, under traditional MIPS, been reporting on practice-wide measures largely irrelevant to their scope of work. 

Who Can Report MVPs

MVPs can be reported by individual MIPS eligible clinicians, single specialty groups, multispecialty groups, or APM Entities. MVPs can also be reported at the subgroup level, which is not an option under traditional MIPS. 

Registration is required. Clinicians must register with CMS as MVP participants within the designated window during the performance year. Choosing an MVP also means committing to the measures within that pathway for the full performance year.

What Scoring Looks Like Under MVPs

Scoring under MIPS Value Pathways largely mirrors traditional MIPS. Performance category weights remain consistent with traditional MIPS, and reweighting policies also align, with one exception: CMS will not reweight the Quality category if a score cannot be calculated because there is no applicable quality measure for the clinician. 

For the 2026 performance year, clinicians reporting an MVP will need to report four quality measures, one improvement activity, and promote interoperability measures, with CMS calculating the Medicare Spending Per Beneficiary measure for the Cost category. 

Where MIPS Reporting Is Headed

CMS has been clear about the direction. Traditional MIPS reporting is being phased out, with MVPs set to become the standard path forward unless clinicians are reporting through the APM Performance Pathway. The 2027 performance year has been referenced as the point after which traditional MIPS would no longer be an option. Practices that have not yet looked into MVPs will need to get familiar with the available pathways and what registration involves before that window closes.

Conclusion

The move from traditional MIPS to MIPS Value Pathways changes how performance gets measured, not just how it gets reported. Specialty-aligned measures give CMS more relevant data and give clinicians a clearer picture of how their work is being assessed. The transition is gradual for now, but the timeline is moving. Organizations that start understanding MVP requirements early will have more room to plan, rather than adjusting under pressure when reporting becomes mandatory.

Persivia offers various health management platforms that help healthcare organizations stay on top of quality program requirements, track performance across measures, and manage reporting without the manual work that typically slows teams down.

7 ACO Success Strategies Every Medical Director Should Know

Medical directors in ACOs carry both clinical and financial responsibility. Quality scores, shared savings targets, care gap rates, total cost of care: all of it runs through leadership decisions. The ACOs consistently hitting their benchmarks are not working harder than the ones that are not. They have clearer ACO success strategies and the operational structure to follow through on them. Here are seven that show up repeatedly in high-performing organizations.

1. Know Your Population Before the Year Begins

Before the performance year starts, the care team needs a clear view of which patients need the most attention, which conditions are unmanaged, and where care gaps already exist. That picture has to be current. Patient data changes constantly, and a risk assessment from three months ago may not reflect where a patient stands today.

2. Build Structure Around Post-Discharge Follow-Up

Readmissions are largely a coordination problem, not a clinical one. What happens between discharge and the first follow-up visit determines whether a patient stabilizes or returns. A follow-up plan, medication review, and monitoring schedule need to be confirmed before the patient leaves, not scheduled later when someone has time.

When post-discharge steps depend on someone remembering to initiate them, patients slip through. A reliable process moves on its own once discharge happens.

3. Close Care Gaps During the Year

Care gaps need to reach the right person while there is still time to act on them. A gap flagged in a report that nobody checks weekly is not a functioning alert system. Prompts during provider visits and timely patient outreach are what actually move gap closure rates.

An ACO that starts addressing gaps in the final quarter of the year has very little room to recover lost ground on quality measures.

4. Eliminate Redundant Services

When providers lack access to a complete patient record, they order tests and procedures that have already been done elsewhere. The patient gets billed twice, and the ACO absorbs the cost at reconciliation. Giving every provider a shared view of what has already happened is the most direct way to reduce this.

5. Monitor Network Utilization

Care delivered outside the ACO network often goes untracked until reconciliation. By that point, there is no opportunity to coordinate or prevent follow-on costs. Keeping visibility into where attributed patients receive care throughout the year is part of managing the total cost of care.

6. Align Provider Incentives With Contract Goals

Providers operating under fee-for-service logic will continue to prioritize volume unless their compensation reflects something different. Tying performance metrics to pay is what shifts daily clinical behavior toward the outcomes a value-based contract requires.

7. Track Quality Measures Throughout the Year

Quality performance reviewed only at year's end leaves no room to respond. Tracking measures throughout the year means a team can address a gap falling short in June rather than finding out in December when nothing can be done. HEDIS, STAR ratings, and HCC coding accuracy all need to be visible while there is still time to act.

Conclusion

These ACO success strategies require more than good intentions. They require a system where the right information gets to the right person while action is still possible. Clinical staff and leadership can only act on what they can see, and they can only act in time if the process does not depend on manual steps to move forward.

Persivia's CareSpace® supports each of these strategies inside one connected platform, covering risk stratification, post-discharge monitoring, care gap management, quality tracking, and network utilization reporting for ACOs running MSSP, ACO REACH, and other value-based programs. See how CareSpace® supports ACO performance.

Digital Health Platforms: Past Challenges and What Comes Next

Healthcare has spent decades buying technology that promised more than it delivered. Systems went in, costs went up, and care teams ended up managing the tools instead of the patients. A Digital Health Platform in 2026 looks nothing like what got sold under that name ten years ago. The difference is worth understanding, both for what went wrong before and for what is actually working now.

What Early Digital Health Got Wrong

Early digital health tools were built to solve one problem at a time. A hospital would have one system for documentation, another for billing, another for outreach, and another for quality reporting. None of them shared data cleanly. Care teams spent as much time moving information between systems as they did using it.

The tools were not necessarily bad. The problem was that they were never designed to work together. Each solved its own problem and stopped there, leaving organizations with a collection of systems and no coherent way to operate across them.

The Data Problem That Kept Coming Back

Social determinants barely made it into the picture. Care managers pulled together whatever they could find from whichever system they had access to that day and made decisions from there. By the time the right information reached the right person, the window to act had often already closed. Connecting all of that data turned out to be a much harder problem than it looked.

Every organization accumulates patient data. Very little of it was usable in real time. Records sat in systems that could not talk to each other. Claims lived separately from clinical data. Digital health platforms were supposed to fix this. Early versions tried. But the integration work proved harder than product roadmaps suggested.

What Changed and Why It Matters Now

Interoperability Moved From Optional to Required

For years, data sharing between systems depended on custom integrations built case by case. That changed when FHIR-based standards moved into enforcement. Interoperability standards, including FHIR R4/R5, USCDI+, and TEFCA, have moved from encouragement to enforcement, accelerating modernization across care settings. 

When data can actually move between systems reliably, a Digital Health Platform can do what it was always supposed to: give care teams a complete, current view of a patient regardless of where care was received.

The Shift From Point Solutions to Unified Platforms

Organizations stopped looking for the best tool for each task and started looking for one environment that handled all of them. The shift happened because the cost of managing multiple disconnected vendors, each with its own data format and integration requirements, became too high.

That shift matters because the problems healthcare organizations face are not isolated. Risk stratification connects to care management. Care management connects to quality reporting. Quality reporting connects to reimbursement. A platform that handles one piece well but requires manual work to connect the others does not solve the underlying problem.

What a Modern Digital Health Platform Actually Does

A modern Digital Health Platform is not a dashboard. It is an operating environment for care delivery.

A current patient record built from EHRs, claims, labs, and social data. Risk scores that update as new information comes in. Care gaps that surface where clinicians are already working, not in a separate tab. Quality measure performance is tracked throughout the year, not just at submission time.

The ones that actually work were built to connect from day one. They did not start as a single-use tool and expand outward. They started with the assumption that data comes from everywhere and needs to end up in one place.

Where Digital Health Platforms Are Heading

AI That Does More Than Flag

AI in early digital health platforms mostly flagged things: a potential risk, a possible gap. The next step is not just identifying a problem. It is doing something about it automatically. Routing outreach, updating care plans, and filling documentation gaps: these used to require a person to connect the dots. Platforms handling this directly are where the real-time savings show up for care teams.

Modular Architecture That Adapts

A large health system and a small ACO do not need the same setup. Platforms that can be configured to fit how an organization actually works, without a full rebuild every time something changes, hold up better as contracts and regulations shift. That flexibility is what separates a platform organization from one that they eventually replace.

Conclusion

Digital health has a long history of tools that worked in demos and fell short in practice. The gap between a promising product and something a care team actually uses every day has always been the hard part. What is different now is that the infrastructure, data standards, integration capabilities, and clinical workflow design have caught up enough that the gap is finally closable for organizations willing to make the right platform choice.

The CareSpace® Digital Health Platform from Persivia has been doing exactly this work for nearly two decades, across more than 200 hospitals and 20 million patients. It connects clinical and claims data, continuously runs risk stratification, surfaces care gaps at the point ofcare, and tracks quality and financial performance in one place. Fororganizations looking at where digital health platforms actually deliver on their promise, see what CareSpace® covers.