2026 MIPS Proposed Rule: What’s Changing with Traditional MIPS?

The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the 2026 performance year, targeting updates for the Traditional Merit-based Incentive Payment System (MIPS). Here’s what clinicians, administrators, and stakeholders need to know about forthcoming changes:

1. Performance Category Weights Stay the Same

For those continuing in Traditional MIPS, the proposed category weights for 2026 remain:

• Quality: 30%

• Cost: 30%

• Improvement Activities: 15%

• Promoting Interoperability: 25%

These proportions retain the current balance between outcome-focused and practice-improvement measures, ensuring continuity for practices.

2. More Emphasis on Digital Quality Measurement

• New digital quality reporting requirements are being phased in, requiring participants to prepare for a future where electronic and digital submissions will be the norm.

• Movement toward digital quality measures (dQMs) aims to enhance timeliness and usefulness of feedback.

3. Updates to Measure Inventories

• New, modified, and retired measures have been proposed across all categories, making it critical for practices to review which offerings affect their specialty or scope.

• Data completeness thresholds may increase, meaning clinicians will likely need to report a higher percentage of eligible cases per measure.

4. Progression of MVPs (MIPS Value Pathways)

• The MVP framework continues to evolve, with new pathways proposed and existing ones refined.

• CMS is pushing for a more specialty- and condition-focused approach, providing clinicians with alternatives that better fit their practice and reducing reporting burden when compared to the traditional model.

5. Payment Model Alignment and APM Incentives

• The rule clarifies conversion factor updates now required by law, differentiating between qualifying and non-qualifying advanced alternative payment model (APM) participants.

• MIPS participants involved in advanced APMs but failing to meet bonus thresholds will see changes in how their performance is handled and scored.

6. Adjusted Performance Thresholds

• As mandated, the minimum score to avoid a penalty will be recalibrated based on historical MIPS performance, reflecting more current data and trends.

7. Administrative Burden Reduction

• CMS continues efforts to streamline reporting, reduce complexity, and allow for more flexibility, particularly in light of the shift toward digital measurement.

Check out the fact sheet and be on the lookout for an upcoming webinar!

Traditional MIPS participants should begin evaluating their data submission processes and readiness for digital quality reporting, while also reviewing changes to measure inventories and performance thresholds. Stakeholder comments are encouraged, with CMS seeking feedback on the pace of digital adoption and burden reduction strategies.

Want personalized MIPS help each month?

We offer expert support in ALL categories on a pay-as-you go basis. You use your EMR and or registry and we help with ALL of the rest to help with Quality, Promoting Interoperability, Improvement Activities, Cost and Submission of all data. 

If you’re ready for a dedicated MIPS expert as part of your team contact us today!

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