CMS QPP and MIPS Updates
The following is communication from the Centers for Medicare & Medicaid Services (CMS) on QPP and MIPS updates.
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The Continued Growth of Direct Secure Messaging
By Kathryn Ayers Wickenhauser – As the ASTP blog indicates, the interoperability landscape has certainly shifted from when the Direct Project was introduced back in 2009/2010. At the time, there were significant government efforts for two interoperable exchange modalities, one for “push,” and one for “query.” Today, both of these modalities continue to grow.
Achieving Widespread Use of Direct Secure Messaging by US Hospitals
By Jordan Everson & Brett Andriesen – The Direct Project created Direct Secure Messaging, a simple, secure, scalable, and standards-based method to send health information between partners and to provide a straightforward pathway to acquire unique provider and organizational addresses to engage in exchange that resembles secure email.
2023 Preview Period for Doctors and Clinicians Is Reopening
CMS is reopening the Preview Period because 17 additional QPP performance measures were recently identified to be included in the CY 2023 QPP public reporting information. CMS also made additional updates and display corrections to the CY 2023 QPP performance data available during the Preview Period that closed in June.
CMS 2026 Proposed Rule for OPPS and ASC
On July 15, 2025, CMS issued a proposed rule that proposes updates to Medicare payment policies and rates for hospital outpatient and Ambulatory Surgical Center services under the Hospital Outpatient Prospective Payment System and ASC Payment System Proposed Rule for calendar year 2026.
CMS Penalties for Directory Errors Loom for Payors
By David Van Houtte – With a recent increase in rules and regulations from CMS, health plans are feeling the pressure of more scrutiny, and the fear of penalties looms. For example, the No Surprises Act, passed in 2022, has already resulted in healthcare facilities, payors, and providers paying more than $11 million in penalties.
Medicaid Budget Cuts Test Risk Adjustment Program Readiness
By Kathryn Eshelman MD MPH – Unlike Medicare Advantage, risk adjustment in Medicaid is a zero-sum game. Medicaid is managed at the state level with fixed budgets, and the slice of the pie your health plan receives depends on the effectiveness of its risk adjustment program.
How Digitization of Patient Access Empowered Patients
By Chelsea Richwine – In 2024, more patients than ever before accessed their medical records online through web browsers and apps to manage their health – here’s why that matters.
CMS Proposes Physician Payment Rule to Significantly Cut Spending Waste
The calendar year 2026 Medicare Physician Fee Schedule proposed rule would advance primary care management through new quality measures, reduce waste and unnecessary use of skin substitutes, and introduce a new payment model focused on improving care for chronic disease management.