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LUGPA Policy Update: MIPS Value Pathway (MVP) for Urology – Optimal Care for Patients with Urologic Conditions

October 2025

The Centers for Medicare & Medicaid Services (CMS) has finalized the Optimal Care for Patients With Urologic Conditions MIPS Value Pathway (MVP ID: M1423) for voluntary reporting beginning in 2025. This marks a major step forward in developing a specialty-specific approach for urology within the Merit-Based Incentive Payment System (MIPS).

Created through a collaborative effort among LUGPA, Johnson & Johnson, and the American Urological Association (AUA), this MVP provides a framework for assessing quality, cost, and improvement activities most relevant to urologic care.

What Are MIPS Value Pathways (MVPs)?

MVPs are CMS’s effort to simplify and modernize MIPS reporting. Instead of selecting from hundreds of unrelated measures, clinicians report on a focused set of quality, cost, and improvement metrics tailored to their specialty. The goals are to:

  • Reduce administrative burden through relevant and streamlined reporting.
  • Improve feedback and benchmarking within the same specialty.
  • Encourage alignment with future specialty-specific alternative payment models (APMs).

Reporting can be done individually, as a group, or as a subgroup—providing flexibility for large or multispecialty practices.

Key Components of the Urology MVP

The Optimal Care for Patients With Urologic Conditions MVP includes 14 quality measures, 17 improvement activities, and 3 cost measures, in addition to Promoting Interoperability and population health requirements.

Quality Measures:
These measures address both oncologic and non-oncologic urologic conditions.

  • Urologic Cancer Measures include treatment adherence for bladder cancer, repeat TURBT for T1 disease, bone density screening for prostate cancer patients on ADT, and tracking post-biopsy complications.
  • General Urology Measures cover urinary incontinence (e.g., plan of care for women 65+), BPH (symptom improvement tracking), and kidney or ureteral stones (urinalysis before procedures, repeat lithotripsy rates).
  • Cross-Cutting Measures evaluate falls screening, surgical risk assessment, social drivers of health, and patient experience (CAHPS for MIPS).

Improvement Activities:
Seventeen activities address practical, patient-centered improvements, such as:

  • Expanding telehealth to improve access and continuity of care.
  • Using patient navigators and shared decision-making tools.
  • Employing quality data from QCDRs for targeted improvement.
  • Implementing programs on health equity, care coordination, and population health management.

Cost Measures:

  • Renal or Ureteral Stone Surgical Treatment.
  • Prostate Cancer (new in 2025).
  • Medicare Spending per Beneficiary (Clinician).
    These measures are claims-based and assess both procedure-specific and overall cost efficiency.

Impact on LUGPA Practices

This MVP provides independent urology groups a path toward streamlined, relevant, and less burdensome reporting while preparing for the broader shift to value-based payment.

Key benefits include:

  • Specialty-specific performance metrics for accurate benchmarking.
  • Simplified compliance through fewer, more meaningful measures.
  • Subgroup reporting that allows urology departments to report independently within multispecialty organizations.
  • Preparation for future APMs and greater readiness for potential mandatory MVP adoption.
  • Focus on access and equity, reflecting LUGPA’s priorities in telehealth and patient-centered care.

Why It Matters

The Urology MVP aligns CMS’s quality reporting system with the clinical realities of urologic practice. By centering on high-impact conditions—such as prostate and bladder cancer, BPH, and urinary incontinence- it ensures MIPS better reflects the outcomes that matter most to patients and providers.

With voluntary reporting in 2025, practices have an opportunity to pilot their data collection and identify challenges before MVP reporting becomes mandatory. The MVP also sets the stage for future advancements in areas like antimicrobial stewardship, opioid management, and advanced prostate cancer care.

Recommendations for LUGPA Members

LUGPA encourages members to:

The Optimal Care for Patients With Urologic Conditions MVP represents a landmark development for urology within Medicare’s value-based framework. By engaging early, LUGPA practices can demonstrate leadership in quality improvement and help shape future reimbursement models that better reflect the value and expertise of independent urologists.

For more information:

Development of a MIPS Value Pathway Reporting Option for Urology Payment
https://reviewsinurology.com/issues/vol/24/no/3/development-of-a-mips-value-pathway-reporting-option-for-urology-payment