The Advantage of Planning Ahead for MIPS 2027

A proposed rule change could affect how outpatient rehab therapy and post-acute and long-term care (PALTC) providers approach value-based care.

Staying ahead of the merit-based incentive payment system (MIPS) is an ever-present effort among both physical therapy and PALTC providers. With specific measures for value-based care and potential payments available for those who meet them, there's good reason to pay attention. Moreover, the framework isn't stagnant. The Centers for Medicare and Medicaid Services (CMS) are already making plans for the next iteration, and smart providers are preparing accordingly.

The MIPS 2027 proposed rule offers a glimpse at what providers should expect in 2028 and beyond. Here's what you need to know. 

Transitioning from Traditional MIPS to MIPS Value Pathways

Perhaps the most notable of the proposed changes is a shift away from traditional MIPS reporting. The MIPS Value Pathways (MVP) reporting framework aims to align quality, cost and improvement activities with specific specialties and patient populations. According to CMS, moving to the MVP model would help reduce reporting complexity while providing stronger performance insights.

CMS plans to sunset traditional MIPS and make the move to MVPs after the 2028 performance year, giving providers time to start transitioning. Though the transition would not become effective until 2029, providers who start the process now can achieve a smoother transition and build valuable experience.

Evolution of Quality Measurement and Interoperability

Significant changes to quality measures are on the table as well. 

The MIPS 2027 proposal adds ten new quality measures while removing twenty. This substantial update aims to support interoperability and data exchange. On top of that, numerous existing measures could undergo revisions while the Outcome and High Priority requirements would sunset in favor of a new Core Measure requirement. 

Changes to interoperability are on the board, too. Electronic Prior Authorizations alongside standardized data exchange and automation take center stage in the proposed updates, encouraging providers to modernize interoperability capabilities. 

These updates are not set in stone. But PALTC and outpatient rehab therapy providers can still use them as guideposts for evolving and strengthening. Providers should take a close look at their quality reporting strategies and technology capabilities ahead of 2027 and work with a healthcare IT platform to shore up weak points.  

Preparing Today for Tomorrow's MIPS Landscape

While the proposed rule is not yet finalized, it paints a clear picture of where CMS has its priorities: digital, automated and standardized are the key terms to plan for the future of health care. Organizations can position themselves for success by proactively modernizing workflows and data exchange capabilities with help from a dedicated healthcare IT provider. Acting now can help providers prepare for smoother adjustment and build toward success. 

To learn more, we invite you to listen to our webinar, Staying Ahead of MIPS 2027: Proposed Rule Changes & Updates.