MACRA

On January 1, 2017, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) reformed the Medicare physician payment system through the creation of the Quality Payment Program, rewarding Medicare providers for the quality and value of care patients receive, rather than for the volume of services provided.

PQRS, MU, and VM points to MACRA and MACRA points to QPP

MIPS

Most providers will be subject to MIPS, the Merit-Based Incentive Payment System, which consists of revised performance categories:

Merit-Based Incentive Payment System 2026

Chart showing merit based incentive payment system: Cost (full year) 30%, Improvement Activities (90 Days) 15%, Promoting Interoperability (180 days) 25%, Quality (full year) 30%

eClinicalWorks can help you navigate every aspect of the new requirements. Our experts have the experience and knowledge you need to choose the right mix of quality measures for your practice.

Maximum Positive MIPS Adjustment

2026 Performance Year

9 percent

MIPS Value Pathways (MVPs)

MVPs are the newest MIPS reporting option (an alternative to “traditional MIPS” and “APM Performance Pathway (APP)”) that you can use to meet your MIPS reporting requirements.

There are several participation options for the MVP method. Providers can report individually, as a single specialty group, a multi-specialty group, a subgroup, or as part of the APM entity. A subgroup would be a subset of providers that are a part of a larger group under the same Tax ID that could form a smaller subgroup to report data for that set of providers.

Participation and Registration

  • Individual
  • Single Specialty Group
  • Multi-Specialty Group
  • Subgroup
  • APM Entity

Providers or groups must register between April 1 and November 30, 2026, indicating which MVP they plan to report and the providers who are part of the group. Under MVP reporting, you would still be responsible to report the same four performance categories as MIPS, but with slightly different requirements.

Available MVPs for 2026 Reporting:

Finalized MVPs:

  • Complete Ophthalmologic Care MVP
  • Dermatological Care MVP
  • Gastroenterology Care MVP
  • Optimal Care for Patients with Urologic Conditions MVP
  • Pulmonology Care MVP
  • Surgical Care MVP
  • Adopting Best Practices and Promoting Patient Safety within Emergency Medicine MVP
  • Advancing Cancer Care MVP
  • Advancing Care for Heart Disease MVP
  • Advancing Rheumatology Patient Care MVP
  • Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes MVP
  • Focusing on Women’s Health MVP
  • Improving Care for Lower Extremity Joint Repair MVP
  • Optimal Care for Kidney Health MVP
  • Patient Safety and Support of Positive Experiences with Anesthesia MVP
  • Prevention and Treatment of Infectious Disorders Including Hepatitis C and HIV MVP
  • Quality Care for Patients with Neurological Conditions MVP
  • Quality Care for the Treatment of Ear, Nose, and Throat Disorders MVP
  • Value in Primary Care MVP
  • Rehabilitative Support for Musculoskeletal Care MVP
  • Quality Care in Mental Health and Substance Use Disorders MVP
  • Diagnostic Radiology MVP
  • Interventional Radiology MVP
  • Neuropsychology MVP
  • Pathology MVP
  • Podiatry MVP
  • Vascular Surgery MVP

APMs

APMs, or Alternative Payment Models, offer additional incentives to practices that adopt risk, provide high-quality, cost-efficient care, and meet certain conditions.

icon of a medical facility

Medical Home

icon of three people

ACO

icon of a money bag

Bundled Payments

Advanced APMs are for practices who are willing to take additional risk based on their patient outcomes. Qualifying Participants (QP) participating in Advanced Alternative Payment Models (AAPM) can earn a 1.8 percent incentive for performance year 2025, and a higher Physician Fee Schedule update for performance years 2025 and beyond.

How eClinicalWorks Can Help

Graphic of a cloud that says anytime, anywhere access

eClinicalWorks helps customers meet complex MACRA/MIPS requirements with free videos, webinars, and documentation. Our consultants work with individual and group practices to navigate the complex regulatory environment in the transition to value-based care, including:

Measuring setup and workflow optimization
Quantifying the frequency of quality measure compliance for patient populations
Navigating performance categories, such as Quality, Promoting Interoperability, and Improvement Activities
Submitting MIPS data to CMS electronically
Selecting measures to maximize practices’  Composite Performance Scores
Training in the use of dashboards and Clinical Quality Worksheets
Assisting with reporting for those in the APM Performance Pathway (APP)

“I had the pleasure of working with my eClinicalWorks MIPS consultant. Without her expertise, I could not have achieved the remarkable scores and incentives I did. She was readily available to answer any questions. I would not want to even attempt to deal with MIPS without help from my trusted eClinicalWorks resource!”
Terry Goldblatt, Center For Dermatology

MIPS

Most providers will be subject to MIPS, the Merit-Based Incentive Payment System, which consists of revised performance categories:

Merit-based Incentive Payment System 2026

pie graph of Merit-based Incentive Payment System. Categories are: program year 2023: quality = 30%, cost = 30%, promoting interoperability = 25%, improvement activities = 15%.

eClinicalWorks can help you navigate every aspect of the new requirements. Our experts have the experience and knowledge you need to choose the right mix of quality measures for your practice.

Maximum Positive MIPS Adjustment

2026 Performance Year

arrow pointing right, and text that reads 2023 performance year

MIPS Value Pathways (MVPs)

MVPs are the newest MIPS reporting option (an alternative to “traditional MIPS” and “APM Performance Pathway (APP)”) that you can use to meet your MIPS reporting requirements.

There are several participation options for the MVP method, Providers can report individually, as a single specialty group, a multi-specialty group, a subgroup, or as part of the APM entity. A subgroup would be a subset of providers that are a part of a larger group under the same Tax ID that could form a smaller subgroup to report data for that set of providers.

Participation and Registration

  • Individual
  • Single Specialty Group
  • Multispecialty Group
  • Subgroup
  • APM Entity

Providers or groups must register between April 1 and November 30, 2026, indicating which MVP they plan to report, and the providers who are part of the group. Under MVP reporting, you would still be responsible to report the same four performance categories as MIPS, but with slightly different requirements.

Available MVPs for 2026 Reporting:

Finalized MVPs:

  • Complete Ophthalmologic Care MVP
  • Dermatological Care MVP
  • Gastroenterology Care MVP
  • Optimal Care for Patients with Urologic Conditions MVP
  • Pulmonology Care MVP
  • Surgical Care MVP
  • Adopting Best Practices and Promoting Patient Safety within Emergency Medicine MVP
  • Advancing Cancer Care MVP
  • Advancing Care for Heart Disease MVP
  • Advancing Rheumatology Patient Care MVP
  • Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes MVP
  • Focusing on Women’s Health MVP
  • Improving Care for Lower Extremity Joint Repair MVP
  • Optimal Care for Kidney Health MVP
  • Patient Safety and Support of Positive Experiences with Anesthesia MVP
  • Prevention and Treatment of Infectious Disorders Including Hepatitis C and HIV MVP
  • Quality Care for Patients with Neurological Conditions MVP
  • Quality Care for the Treatment of Ear, Nose, and Throat Disorders MVP
  • Value in Primary Care MVP
  • Rehabilitative Support for Musculoskeletal Care MVP
  • Quality Care in Mental Health and Substance Use Disorders MVP
  • Diagnostic Radiology MVP
  • Interventional Radiology MVP
  • Neuropsychology MVP
  • Pathology MVP
  • Podiatry MVP
  • Vascular Surgery MVP

APMs

APMs, or Alternative Payment Models, offer additional incentives to practices that adopt risk, provide high-quality, cost-efficient care, and meet certain conditions.

icon of a medical facility

Medical Home

icon of three people

ACO

icon of a money bag

Bundled Payments

Advanced APMs are for practices who are willing to take additional risk based on their patient outcomes. Qualifying Participants (QP) participating in Advanced Alternative Payment Models (AAPM) can earn a 1.8 percent incentive for performance year 2025, and a higher Physician Fee Schedule update for performance years 2025 and beyond.

How eClinicalWorks Can Help

Graphic of a cloud that says anytime, anywhere access

eClinicalWorks helps customers meet complex MACRA/MIPS requirements with free videos, webinars, and documentation. Our consultants work with individual and group practices to navigate the complex regulatory environment in the transition to value-based care, including:

Measuring setup and workflow optimization
Quantifying the frequency of quality measure compliance for patient populations
Navigating performance categories, such as Quality, Promoting Interoperability, and Improvement Activities
Submitting MIPS data to CMS electronically
Selecting measures to maximize practices’  Composite Performance Scores
Training in the use of dashboards and Clinical Quality Worksheets
Assisting with reporting for those in the APM Performance Pathway (APP)

“I had the pleasure of working with my eClinicalWorks MIPS consultant. Without her expertise, I could not have achieved the remarkable scores and incentives I did. She was readily available to answer any questions. I would not want to even attempt to deal with MIPS without help from my trusted eClinicalWorks resource!”
Terry Goldblatt, Center For Dermatology