Why this matters now
The same CY 2027 proposed rule from CMS carries a change quality teams have watched for years: traditional MIPS reporting would end. Beginning with the 2029 performance period, CMS proposes to sunset traditional MIPS and make MIPS Value Pathways (MVPs) the primary reporting option. Clinicians would have until the end of 2028 to move to an MVP unless they participate in a MIPS APM and report the APM Performance Pathway. The runway looks long. The planning starts now.
What CMS proposed
CMS launched MIPS in 2017 to move Medicare away from fragmented fee-for-service toward payment tied to quality, outcomes, and value. Nearly a decade in, the agency wants to complete the shift. The proposal would:
- Sunset traditional MIPS beginning with the 2029 performance period.
- Establish MVPs as the primary reporting option in MIPS.
- Add three new MVPs focused on diabetes, hypertension, and hospital-based care.
- Give roughly 98 percent of specialties a relevant MVP reporting option if finalized.
- Introduce new MIPS Core Measures beginning in 2027, requiring every clinician to report at least one measure fundamental to their specialty and patient population.
CMS also proposed reforming the APM incentive payment to close a loophole. The agency estimates the current structure would send $2.38 billion in windfall payments over the next decade to clinicians who do not participate in APMs. The reform would direct those incentives toward providers delivering value-based care.
What this means for quality and Stars teams
The move narrows reporting toward measures relevant to each specialty and patient population, which changes how you build provider quality programs. Consistent Core Measures across clinicians produce cleaner, more comparable quality data. Cleaner data strengthens the evidence base you draw on for Stars strategy, provider profiling, and population health targeting.
The three condition-focused MVPs point to where CMS wants attention. Diabetes and hypertension drive cost and outcomes across Medicare populations. Quality programs aligned to these measures now will sit closer to federal priorities as the transition takes hold.
Practical takeaways
- Map which of your contracted clinicians report traditional MIPS today and when each would need to move to an MVP.
- Track the three new MVPs, since diabetes and hypertension overlap heavily with MA quality and risk work.
- Prepare provider partners for the 2027 Core Measures requirement, so the first reporting year does not surprise your teams.
- Watch the APM incentive reform, which reshapes the financial case for providers weighing APM participation.
What to watch next
The proposed rule is open for public comment, so measure specifications and timelines will shift before anything finalizes. Raise these questions with your team: Which of your provider partners face the biggest adjustment moving to MVPs? How will the new Core Measures align with the quality metrics already central to your Stars strategy? Where do the diabetes and hypertension MVPs intersect with your risk adjustment and care management priorities?
Quality and Stars leaders work through exactly these questions at RISE quality and Star Ratings events, where you compare approaches with peers facing the same CMS timeline.