The Centers for Medicare & Medicaid Services (CMS) has finalized the 2026 Merit-based Incentive Payment System (MIPS) policies, continuing its shift toward value-based, specialty-aligned performance measurement. For clinicians, independent practices, and office managers, the 2026 Final Rule brings important updates, especially around MIPS Value Pathways (MVPs), cost measurement, and Promoting Interoperability. 

Here’s a clear breakdown of what matters most and how practices can prepare. 

1. CMS Continues the Transition to MIPS Value Pathways (MVPs) 

CMS is reinforcing MVPs as the future of MIPS reporting. MVPs are designed to align quality, cost, and improvement activities around a specific specialty or condition, reducing reporting burden while improving clinical relevance. 

What’s New for 2026 

• Six new MVPs finalized for the 2026 MIPS performance year (impacting the 2028 payment year) 

• Updates to 21 existing MVPs, including measure removals, additions, and refinements 

• Continued emphasis on specialty-specific outcomes rather than generic measures

Examples of newly finalized MVPs include: 

• Diagnostic Radiology 

• Interventional Radiology 

• Neuropsychology 

• Pathology 

• Podiatry 

• Vascular Surgery

This expansion allows more specialists and independent practices to participate in clinically meaningful reporting instead of traditional MIPS.  

1. MVP Reporting Requirements: What Practices Must Submit 

While MVPs streamline reporting, the core requirements remain consistent:  

Quality Performance Category 

• Report 4 quality measures 

• At least 1 must be an outcome measure (or high-priority measure if no outcome is available) 

• Some measures may be claims-based and calculated by CMS, reducing manual reporting

Improvement Activities 

• Attest to 1 improvement activity 

• Applies to clinicians, groups, and subgroups (including those with special status)

Cost Performance Category 

• Fully calculated by CMS using claims data 

• No submission required by the practice 

• Includes episode-based and population-based cost measures tied to MVPs

Foundational Layer (Applies to All MVPs) 

• Population Health Measures (claims-based, CMS calculated) 

• Promoting Interoperability (PI) objectives and measures

This structure ensures consistent benchmarking across MVPs while preserving flexibility at the specialty level.  

1. Cost Measures: More Transparency, Less Immediate Risk 

A key takeaway for 2026 is CMS’s approach to cost accountability.  

Two-Year Informational-Only Period 

• New cost measures finalized for MVPs will have a 2-year informational feedback period 

• Clinicians receive performance feedback only 

• Scores will not impact the MIPS final score during this period

This gives practices time to: 

• Understand cost attribution 

• Identify care variation 

• Adjust workflows before financial impact

CMS also finalized updates to the Total Per Capita Cost (TPCC) measure, signaling ongoing refinement of cost methodologies.  

1. Promoting Interoperability (PI): Targeted Updates for 2026 

Promoting Interoperability remains a required component unless reweighted. CMS finalized several important changes:  

Key PI Updates 

• Electronic Case Reporting suppressed for the CY 2025 performance period 

• Attestation still required 

• Updates to Security Risk Analysis and SAFER Guide measures 

• New optional bonus measure: 

• Public Health Reporting using TEFCA (Trusted Exchange Framework and Common Agreement)

For office managers and IT teams, this means continued focus on EHR security, interoperability, and public health data exchange, but with some flexibility built in.  

1. Specialty Practices Benefit Most from MVP Expansion 

Independent and specialty practices stand to gain the most from the 2026 MVP framework:  

Why MVPs Matter for Independent Practices 

• Measures are clinically relevant, not generic 

• Less “checkbox” reporting 

• Better alignment between quality and cost 

• Easier benchmarking against peers in the same specialty

Specialties such as radiology, pathology, podiatry, vascular surgery, oncology, cardiology, dermatology, and women’s health now have clearer reporting pathways tailored to their workflows and patient populations.  

1. What Clinicians and Practice Leaders Should Do Now 

Although the 2026 performance year may feel distant, preparation should start now.  

Action Steps 

1. Evaluate MVP eligibility for your specialty 

1. Compare traditional MIPS vs. MVP reporting 

1. Review cost feedback reports once available 

1. Engage clinicians early around outcome measures 

1. Ensure EHR systems support PI and MVP reporting needs

Early planning can help practices avoid penalties, capture incentives, and reduce administrative burden.  

Conclusion 

The MIPS 2026 Final Rule reflects CMS’s long-term strategy: fewer generic measures, more meaningful specialty-driven performance, and a gradual but firm move toward value-based care.  

For healthcare providers, independent medical practices, clinicians, and office managers, MVPs are no longer optional to understand, they are becoming the default path forward. 

Practices that proactively align workflows, technology, and quality strategies with MVPs will be best positioned for success in future MIPS payment years.  

How TriumpHealth Helps Practices Succeed For MIPS 2026 

Navigating the expanding MIPS and MVP landscape requires more than basic reporting; it demands specialty expertise, proactive planning, and continuous performance optimization. TriumpHealth’s MIPS consulting team partners with clinicians, independent practices, and office managers to turn the complexity of the 2026 MIPS Final Rule into a clear, manageable, and penalty-avoidance strategy. To learn how we can help you succeed in 2026, you can schedule a consultation today  or contact us at [email protected] or (888) 747-3836 x0.