Traditional MIPS has a death date. CY 2029 is the cutoff. MVPs become the only reporting option for non-APM clinicians after 2028. Three performance years to rebuild.
93% of MIPS reporters earned a positive adjustment in 2017-2019. The largest was 1.88%. Everyone passed, nobody got paid, every practice paid real overhead to get there.
The new core measure rule is the sharpest edge. Miss the required core measure without attestation and you get zero out of ten quality points. A ten-point crater at 75-point threshold flips bonuses to penalties.
43 of the 180 surviving quality measures change specification in one rule cycle. The AHA walked away from major cardiology measures. Every registry built around those measures owns a migration project now.
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