The Centers for Medicare & Medicaid Services (CMS) recently finalized a new Merit-based Incentive Payment (MIPS) System Value Pathway (MVP) specifically for vascular surgery — an important milestone for our specialty and the Society for Vascular Surgery (SVS).
Developed by the SVS Quality and Performance Metrics Committee (QPMC) under the leadership of Evan Lipsitz, MD, and Caitlin W. Hicks, MD, MS, with invaluable support from SVS Manager of Quality Improvement and Practice Carrie McGraw, the Vascular Surgery MVP has been officially incorporated into the CMS 2026 Final Rule. This milestone represents years of dedicated effort to ensure that vascular surgeons at last have a reporting pathway that reflects our practice, reflects meaningful outcomes for vascular patients, and reduces the administrative burden of traditional MIPS.
For many vascular surgeons, the mechanics of the Quality Payment Program (QPP) and MIPS felt opaque and disconnected from day-to-day clinical care. Yet these programs shape reimbursement, influence public reporting, and increasingly inform CMS’ understanding of quality care. The Vascular Surgery MVP offers a coherent reporting pathway for vascular surgeons that organizes measures around the work we actually do on behalf of our patients and creates a more straightforward, clinically grounded reporting experience.
Understanding the MVP framework
MVPs were created to address well-recognized limitations of traditional MIPS, which often required clinicians to select measures from an excessively broad and often clinically irrelevant menu. MVPs replace this approach with narrowly defined specialty-specific sets of measures that align quality, cost, improvement activities, and interoperability requirements under a consistent framework. Beginning with the 2026 performance year, vascular surgeons will be able to report using the new Vascular Surgery MVP. CMS anticipates MVPs will become the dominant reporting mechanism for all clinicians in future years.
How the vascular surgery MVP was built
The SVS QPMC developed the Vascular Surgery MVP through extensive review of available MIPS measures, registry experience, and continuous dialogue with CMS. The committee prioritized measures that reflect the conditions we treat most frequently, that have a strong evidence base, and that distinguish meaningful variation in performance.
This work was grounded in a simple goal: to create a high-value pathway that accurately reflects the complexity and quality of vascular surgical care and can be adopted successfully across diverse practice settings.
What components will vascular surgeons report under the MVP?
The Vascular Surgery MVP, as all MVPs, includes four core components: quality, cost, improvement activities, and a foundational layer (population health and promoting interoperability). Each category has defined reporting expectations, which are consistent across all MVPs and easier to navigate than the traditional MIPS structure.
Quality Category: Must report 4 measures (at least 1 outcome measure)
Under this MVP, vascular surgeons select four quality measures from a curated set, with at least one required to be an outcome measure. The quality measures are organized across clinical areas central to vascular practice. They include procedure-specific outcomes for endovascular aneurysm repair and carotid artery revascularization; postoperative outcomes such as unplanned reoperation, readmission, and surgical site infection; dialysis access functional outcomes; communication-focused measures such as closing the referral loop; and broader patient-centered care practices like glycemic assessment, tobacco cessation, medication reconciliation, and cardiovascular risk reduction.
The structure of the MVP quality category ensures a clinically meaningful approach to quality reporting: surgeons choose from measures that are already common in perioperative and vascular quality frameworks, rather than from an overwhelming list untethered to our specialty.
Cost Category: CMS-Calculated, and All MVP-Specific Cost Measures Apply
The cost component of an MVP does not require manual reporting. CMS calculates performance using administrative claims, and all cost measures linked to the MVP apply automatically. For vascular surgery, these include episode-based costs for revascularization for chronic limb-threatening ischemia, hemodialysis access creation, and the Medicare Spending per Beneficiary (MSPB) measure. These episodes are directly aligned with common vascular procedures and reinforce responsible resource utilization within high-risk patient populations.
Improvement Activities: Attest to 1 Activity
Clinicians attesting under the Vascular Surgery MVP will select one improvement activity from a focused list that includes patient-reported outcome tool implementation, perioperative care coordination, telehealth to expand access, medication and anticoagulation management, advance care planning, and participation in patient safety organizations. Because the MVP tightly links improvement activities to the overarching goals of the pathway, the options to report on improvement activities are more intuitive and clinically aligned than those in traditional MIPS.
Foundational Layer: Population Health + Promoting Interoperability
All MVPs include a foundational layer with two parts:
- Population health: CMS automatically assigns the higher of two claims-based population health measures, requiring no action from the reporting clinician.
- Promoting Interoperability: Clinicians must report the same electronic health record–based measures required under traditional MIPS unless they qualify for reweighting.
Why this MVP matters for vascular surgeons
The Vascular Surgery MVP brings clarity and vascular-specific clinical relevance to a government-mandated quality reporting program that has historically felt fragmented and burdensome. By narrowing reporting to measures that reflect the essential domains of vascular practice, it creates a structure that aligns federal reporting with the way we conceptualize quality and outcomes as a specialty. It also reduces the administrative lift by restricting the number of measures required and streamlining selection.
Importantly, the Vascular Surgery MVP positions the SVS to shape national definitions of quality more effectively. The curated measure set highlights the risk profile and complexity of the patients we treat while reinforcing the specialty’s commitment to evidence-based, high-quality care.
What’s next for the vascular surgery MVP?
The inclusion of the Vascular Surgery MVP in the 2026 Final Rule is both a milestone and a beginning. It marks the first time vascular surgery has had a dedicated, specialty-aligned pathway within MIPS, and is a reporting pathway shaped by vascular surgeons for vascular surgeons. As CMS continues moving toward MVP-centered reporting, this new option ensures our specialty is represented accurately and fairly within national quality programs.
The SVS encourages its members to familiarize themselves with the structure and requirements of the Vascular Surgery MVP before the 2026 reporting year. The SVS QPMC is diligently working to develop additional quality measure that will further support our members’ meaningful reporting experience. Our ultimate goal is for the Vascular Surgery MVP to serve not only as a CMS compliance mechanism, but as a meaningful reflection of the value vascular surgeons bring to patient care every day.
How to learn more
A summary of the Vascular Surgery MVP can be found on the CMS website: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3370/2026-Proposed-and-Modified-MVPs-Guide.pdf. Stay tuned for a related Audible Bleeding Episode that will offer a Q&A on pertinent questions about the MVP!
Other related and valuable resources can be found at: https://vascular.org/advocacy/macra-qpp-resources
