Optimal Care for Kidney Health: Development of a Merit-based Incentive Payment System (MIPS) Value Pathway.

Area of Science:

• Nephrology
• Health Policy
• Quality Improvement

Background:

• The Merit-based Incentive Payment System (MIPS) has limitations in assessing nephrology care, including administrative burden and relevance.
• Existing MIPS measures do not adequately capture the nuances of kidney disease management.
• There is a need for a specialized, valid quality assessment program for nephrology.

Purpose of the Study:

• To develop an optimal care pathway for kidney health within the MIPS framework.
• To create a more relevant and meaningful quality assessment program for nephrology practices.
• To streamline quality measure selection for nephrologists participating in MIPS.

Main Methods:

• An iterative consensus-building process by the American Society of Nephrology Quality Committee (May 2020-July 2022).
• Two rounds of ranked-choice voting to select quality metrics, improvement activities, and cost measures.
• Collaboration with the Centers for Medicare & Medicaid Services (CMS) MVP Development Team and submission through the Measures Under Consideration process.

Main Results:

• The Optimal Care for Kidney Health MIPS Value Pathway (MVP) was finalized and published in the 2023 Medicare Physician Fee Schedule Final Rule.
• The MVP includes measures on ACE inhibitor/ARB use, hypertension control, readmissions, acute kidney injury requiring dialysis, and advance care planning.
• This represents a significant step in tailoring MIPS for nephrology care.

Conclusions:

• The nephrology MVP streamlines measure selection, enhancing the assessment of kidney care quality.
• This collaborative effort serves as a model for specialty organizations and regulatory agencies in policymaking.
• The pathway aims to improve patient outcomes and reduce healthcare costs in nephrology.