New model for MIPS is coming, while Advanced APMs get a tough break

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains proposed changes to CMS’s Quality Payment Program for calendar year 2023, with emphasis on the new MIPS Value Pathways approach, subgroup participation concepts, and updates affecting Advanced APM participants. It is relevant to clinicians, group practices, APM entities, registry vendors, and billing/coding professionals tracking federal payment policy, reporting structure changes, and performance category requirements.

Why This Topic Matters

The proposal signals a significant shift in how MIPS participation may be organized and how clinicians and groups will report performance in coming years. It also highlights policy changes that could affect financial incentives, reporting workflows, and eligibility considerations for practices participating in APMs and MIPS.

What You Will Learn

  • How CMS is structuring the new MIPS Value Pathways framework for 2023 and beyond.
  • What subgroup participation means for different practice structures and specialties.
  • Which broad policy changes are proposed for Advanced APM participants.
  • How core MIPS scoring elements and reporting thresholds are expected to change or remain stable.

Who Should Read This

  • Physicians and eligible clinicians
  • Medical group administrators
  • Quality reporting staff
  • Revenue cycle and compliance teams
  • ACO and APM participants
  • Registry and EHR vendors

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