.png){kind=small}
The Quality Payment Program (QPP) continues to evolve, and the 2026 Merit-based Incentive Payment System (MIPS) requirements bring new challenges and opportunities for healthcare providers. Hospital administrators, IT professionals, nursing staff, analysts, and billing companies must understand these updates to improve their MIPS scores effectively. This post outlines practical strategies to help your organization succeed under the 2026 MIPS track, focusing on actionable steps that align with the latest program requirements.
Understand the 2026 MIPS Performance Categories and Weights
MIPS scoring in 2026 continues to be based on four performance categories, but the weightings and requirements have shifted slightly. Knowing these changes helps prioritize efforts:
Quality: 30% of the total score. Providers must report on at least 6 quality measures, including one outcome or high-priority measure.
Cost: 30% of the total score. Cost measures are calculated from claims data, so providers have limited control but can influence through care coordination.
Improvement Activities: 15% of the total score. Activities must be selected from the updated list reflecting current healthcare priorities.
Promoting Interoperability: 25% of the total score. Focuses on the use of certified electronic health record technology (CEHRT) to improve patient care.
Aligning your team’s efforts with these categories ensures resources are used efficiently to maximize your score.
Build a Strong Data Collection and Reporting System
Accurate and timely data submission is critical. The 2026 program emphasizes data integrity and completeness. Here’s how to strengthen your data processes:
Use certified EHR systems that comply with the latest interoperability standards.
Automate data extraction and reporting to reduce errors and delays.
Train staff on documentation best practices to capture all required data points.
Conduct regular audits to identify gaps or inconsistencies before submission deadlines.
Select Quality Measures That Reflect Your Practice Strengths
Choosing the right quality measures can significantly impact your score. The 2026 program encourages providers to select measures that align with their patient population and clinical expertise. Consider these tips:
Prioritize outcome and high-priority measures, as they carry more weight.
Avoid measures with low performance or limited data availability.
Use historical performance data to identify areas where improvement is achievable.
Collaborate with clinical teams to ensure measures are relevant and feasible.
A community hospital focusing on chronic disease management selected measures related to diabetes control and hypertension, resulting in a 10% improvement in their quality score.
Engage in Meaningful Improvement Activities
Improvement activities remain a vital part of MIPS scoring. The 2026 list includes new activities emphasizing health equity, patient safety, and care coordination. To maximize points:
Choose activities that your organization can implement fully and document easily.
Focus on activities that align with your strategic goals, such as expanding telehealth or enhancing care transitions.
Partner with community organizations to support population health initiatives.
Track progress and outcomes to demonstrate meaningful engagement.
For instance, a nursing team that implemented a patient education program on medication adherence reported better patient outcomes and earned full credit for the activity.
Optimize Promoting Interoperability Performance
Promoting Interoperability (PI) requires providers to use CEHRT to share data and engage patients. The 2026 requirements focus on:
Electronic prescribing and medication reconciliation.
Patient electronic access to health information (think: your patient portal PLUS Apple Health integration).
Secure messaging between patients and providers - enable appointment requests, eRx refills and messaging to clinicians.
Public health and clinical data exchange.
To improve your PI score:
Ensure your EHR system is updated and certified for 2026/HTI-I standards.
Train staff on using EHR features effectively - read release notes!
Encourage patients to use portals and secure messaging (give aways work wonders)!
Participate in health information exchanges (either regional/state or vendor-based/national HIEs).
Monitor Cost Measures Through Care Coordination
While cost measures are calculated from claims data, providers can influence them by improving care coordination and reducing unnecessary services. Strategies include:
Reviewing data that contributes to your Cost score. This is available on QPP approximately 6-9 months after attestation.
Implementing care pathways to avoid redundant tests.
Enhancing discharge planning to reduce readmissions.
Using data analytics to identify high-cost patients and intervene early.
Collaborating with payers to align incentives.
Prepare for MIPS Submission and Avoid Penalties
Meeting deadlines and submission requirements is essential to avoid payment penalties. Follow these steps:
Review CMS submission deadlines and requirements early.
Use the CMS Quality Payment Program portal to track submissions.
Validate data before submission to catch errors.
Consider professional support for complex reporting.
Organizations that prepared early and used submission checklists avoided last-minute issues and secured positive payment adjustments.
Final Thoughts on Maximizing Your 2026 MIPS Score
Success in the 2026 MIPS program requires a clear understanding of updated requirements and a coordinated approach across departments. Focus on selecting relevant quality measures, engaging in meaningful improvement activities, optimizing interoperability, and managing costs through care coordination. Strong data management and timely submission complete the picture.