Skip to content

MVP: Optimal Care for Kidney Health

Most applicable medical specialty: Nephrology

The Optimal Care for Kidney Health MVP focuses on the clinical theme of providing fundamental treatment
and management of costly clinical conditions that contribute to, or may result from, kidney disease.

Quality

To fulfill quality requirements:

  1. You must select 4 quality measures from the list below
  2. (exception for clinicians in a small practice – see # 4 below)
  3. At least 1 measure must be an outcome measure
    • If no outcome measures are available, you may report a high priority measure.
  4. If you are part of a small practice (i.e., 15 or fewer clinicians) reporting quality measures through Medicare Part B claims, you don’t need to report additional measures beyond the Medicare Part B claims measures available in this MVP. Reporting all of the Medicare Part B claims measures in this MVP will fulfill your quality reporting requirements.
  5. You must collect data for each measure for the 12-month performance period of the associated performance year (e.g., January 1, 2025 – December 31, 2025).

TIP: For small practices (participating at the individual, group or subgroup level) reporting Medicare Part B claims measures: To meet data completeness requirements, you’ll need to start reporting the Medicare Part B claims measures in your selected MVP in January 2025, prior to the MVP registration period.

TIP: Make sure that you select measures that are appropriate to your patient population. Measures that don’t meet case minimum or data completeness criteria will earn zero points.

IDTitleSpecs
001Diabetes: Hemoglobin A1c
(HbA1c) Poor Control (>9%)
Details
047Advance Care PlanDetails
130Documentation of Current
Medications in the Medical Record
Details
236Controlling High Blood PressureDetails
482Hemodialysis Vascular Access: Practitioner
Level Long-term Catheter Rate
Details
487Screening for Social Drivers of HealthDetails
488Kidney Health EvaluationDetails
489Adult Kidney Disease: Angiotensin Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) TherapyDetails
493Adult Immunization StatusDetails
495Ambulatory Palliative Care Patients’ Experience of Feeling Heard and UnderstoodDetails
503Gains in Patient Activation Measure (PAM) Scores at 12 MonthsDetails
510First Year Standardized Waitlist Ratio (FYSWR)Details
511Percentage of Prevalent Patients Waitlisted (PPPW) and Percentage of Prevalent Patients Waitlisted in Active Status (aPPPW)Details

Improvement Activities

To fulfill improvement activity requirements:

1. You must report 1 improvement activity from the list below.

Beginning in 2025, improvement activities don’t have assigned weights.

IDTitle
IA_AHE_3Promote Use of Patient-Reported
Outcome Tools
IA_AHE_9Implement Food Insecurity and Nutrition Risk Identification and Treatment Protocols
IA_BE_4Engagement of patients through implementation of improvements in patient portal
IA_BE_6Regularly Assess Patient Experience of Care and Follow Up on Findings
IA_BE_14Engage Patients and Families to Guide Improvement in the System of Care
IA_BE_15Engagement of Patients, Family, and Caregivers in Developing a Plan of Care
IA_BE_16Promote Self-management in Usual Care
IA_CC_2Implementation of improvements that contribute to more timely communication of test results
IA_PM_26Vaccine Achievement for Practice Staff: COVID-19, Influenza, and Hepatitis B
IA_CC_13Practice Improvements to Align with OpenNotes Principles
IA_MVPPractice-Wide Quality Improvement in MIPS Value Pathways
IA_PCMHElectronic submission of Patient Centered Medical Home accreditation
IA_PM_11Regular review practices in place on targeted patient population needs
IA_PM_13Chronic Care and Preventative Care Management for Empaneled Patients
IA_PM_16Implementation of medication management practice improvements
IA_PSPA_16Use decision support—ideally platform-agnostic, interoperable clinical decision support (CDS) tools —and standardized treatment protocols to manage workflow on the care team to meet patient needs.

Cost

Important information to consider:

  1. You don’t have to submit any data for this performance category. We’ll use Medicare claims data to
    calculate your cost measure performance.

    (You don’t select cost measures during MVP registration. CMS will calculate your performance
    on all the cost measures included in the MVP based on available Medicare claims data.)
  2. You’ll only be scored on the cost measures in this MVP for which you meet or exceed the established
    case minimum.
IDTitleSpecs
COST_AKID_1Acute Kidney Injury Requiring
New Inpatient Dialysis
Details
COST_CKD_1Chronic Kidney Disease (CKD) episode-based cost measureDetails
COST_ESRD_1End-Stage Renal Disease (ESRD) episode-based cost measureDetails
COST_KTM_1Kidney Transplant Management episode-based cost measureDetails
TPCC_1Total Per Capita Cost (TPCC)
Details