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Author: Lauren Brown

2025 QPP Data Submission Is Now Open

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CMS has officially opened data submission for the 2025 Quality Payment Program (QPP) performance year. Eligible clinicians and practices can submit or update their data through the QPP portal now through March 31, 2026, at 8:00 p.m. ET. During this period, providers can submit their own MIPS data or review data submitted on their behalf by a third party. It’s important to carefully review all reported information before the deadline, as data cannot be corrected…
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Flu Hospitalizations Reach Third-Highest Early-Season Level in 15 Years

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According to the CDC’s latest FluView report, flu hospitalizations are at the third-highest level for this point in the season in 15 years, with a cumulative hospitalization rate of 6.9 per 100,000 for the week ending Dec. 6. Weekly hospitalizations also increased to 2.2 per 100,000, up from 1.7 the week prior. Resource: Flu admissions hit third-highest early-season level in 15 years

CMS Releases New Medicare Data Updates for 2024–2025

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CMS has released several updated datasets and resources providing insights into Medicare beneficiaries, facility performance, and telehealth trends: Medicare Current Beneficiary Survey (MCBS) – 2024 Updates: Cost Report Public Use Files – 2023: Medicare Telehealth Trends – Q1 2025: Medicare Beneficiaries at a Glance – 2023: Medicare Enrollment – August 2025: These updates provide a clear snapshot of Medicare utilization, coverage trends, telehealth adoption, and facility-level performance, making it easier for providers, researchers, and policymakers…
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CMS Shares Key December 2025 Updates for Medicare Providers

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CMS recently highlighted several important updates for providers, including the new MAHA ELEVATE Model, upcoming requirements for the Outpatient Prospective Payment System Drug Acquisition Cost Survey, and guidance to help critical access hospitals avoid claim denials. The update also covers compliance tips, coding and payment changes, upcoming webinars like the PEPPER session, and recent MLN Matters articles. For the full set of updates and resources from CMS’ Medicare Learning Network, see the details here.

New CMS LEAD Model Aims to Expand Access to Accountable Care and Support High-Needs Patients

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CMS has announced the Long-term Enhanced ACO Design (LEAD) Model, the Innovation Center’s next Accountable Care Organization (ACO) initiative. LEAD is designed to bring more providers into the ACO framework, including those who have historically faced barriers to participation, such as smaller, independent, or rural-based practices. The model also emphasizes care for patients with high needs, including dual eligibles and individuals who are homebound or home-limited. LEAD incorporates an improved benchmarking methodology and other design…
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CMS Publishes CY 2023 QPP Performance Information

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The Centers for Medicare & Medicaid Services (CMS) has released calendar year (CY) 2023 Quality Payment Program (QPP) performance information for clinicians, groups, virtual groups, and Accountable Care Organizations (ACOs). This data is now available in the Provider Data Catalog (PDC) and on clinician and group profile pages in the Medicare.gov Care Compare tool. The publicly reported information includes final Merit-based Incentive Payment System (MIPS) scores across each performance category, the names of Advanced Alternative…
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CMS Updates QPP Tools and Resources for 2025 and 2026

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CMS has released several updates to the Quality Payment Program (QPP), including new APM participation snapshots, approved registries for the 2026 performance year, website enhancements, and rural status updates. These changes are intended to help clinicians and organizations verify participation status and prepare for upcoming reporting requirements. New 2025 APM Participation Snapshots Available CMS updated the QPP Participation Status Tool using the second and third snapshots of 2025 APM data. The tool reflects Qualifying APM Participant (QP)…
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An Alabama Hospital Recognized on Becker’s 2025 “Great Hospitals in America” List

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Becker’s Hospital Review has released its 2025 “Great Hospitals in America” list, recognizing hospitals nationwide for exceptional clinical performance, patient safety, and a strong commitment to innovation, research, and education. These organizations have also earned distinction from leading rankings and accreditation bodies such as U.S. News & World Report, Healthgrades, CMS, and The Leapfrog Group. UAB Hospital in Birmingham was the only hospital in Alabama to make the 2025 list, highlighting the state’s representation among…
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CMS Proposes Two New Medicare Drug Pricing Models to Reduce Costs

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CMS has proposed two new drug pricing models designed to reduce Medicare spending by linking U.S. payments to international pricing benchmarks. Announced by the CMS Innovation Center, the proposals—GUARD and GLOBE—aim to improve affordability for beneficiaries while supporting the long-term sustainability of the Medicare program. Key elements of the proposal include: Resource: CMS proposes 2 Medicare drug pricing models

CMS Releases Updated 2026 QRDA III Implementation Guide for Eligible Clinicians

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CMS has published the updated 2026 Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG) for Eligible Clinicians, incorporating changes finalized in the 2026 Medicare Physician Fee Schedule (PFS) Final Rule released on October 31, 2025. The updated guide outlines technical and reporting requirements for submitting electronic clinical quality measures (eCQMs) for Calendar Year 2026 quality programs. Key updates include the addition of new MIPS Value Pathway (MVP) identifiers across several specialties, new eCQM…
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CMS Releases 2026 QCDR Measure Specifications for MIPS Reporting

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CMS has published the 2026 Qualified Clinical Data Registry (QCDR) Measure Specifications, providing clinicians and organizations with an early look at quality measures available for the upcoming MIPS performance year. Released on December 22, 2025, the specifications allow clinicians, groups, virtual groups, subgroups, and APM Entities—including Medicare Shared Savings Program ACOs—to identify QCDR measures that align with their specialty and reporting needs. The file includes a full list of CMS-approved QCDR measures and identifies which…
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CMS Releases Latest Medicare Diabetes Prevention Program (MDPP) Bulletin

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The Centers for Medicare & Medicaid Services (CMS) has released the latest edition of the Medicare Diabetes Prevention Program (MDPP) Bulletin, the agency’s quarterly newsletter for the MDPP community. Published by the CMS MDPP Team, the bulletin provides updates, resources and insights to support organizations and professionals working to prevent or delay the onset of Type 2 diabetes among Medicare beneficiaries. This edition includes: CMS encourages MDPP suppliers to review the newsletter and share it…
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