Six Concurrent CMS Programs, One Unified Analytics Platform
No other healthcare system in the world runs this many simultaneous quality reporting programs. Vizier is built to track all of them from a single data upload — no separate portals, no duplicate data entry.
Merit-based Incentive Payment System
The primary MACRA QPP track. Four categories: Quality (30%), Cost (30%), Promoting Interoperability (25%), Improvement Activities (15%). 2026 performance year carries up to ±9% payment adjustment.
Hospital Readmissions Reduction Program
Penalizes hospitals with excess 30-day readmissions for AMI, HF, pneumonia, COPD, hip/knee arthroplasty, and CABG. Maximum 3% reduction in all Medicare inpatient payments. 2,500+ hospitals penalized annually.
Hospital Value-Based Purchasing
Adjusts Medicare DRG payments based on quality performance across Safety, Clinical Care, Efficiency & Cost Reduction, and Patient and Caregiver-Centered Experience domains.
Inpatient Prospective Payment System
DRG-based payment system for acute inpatient hospital stays. Accurate DRG assignment, complication and comorbidity (CC/MCC) capture, and case mix index optimization are critical to revenue integrity.
Outpatient Prospective Payment System
APC-based payment system for hospital outpatient services. Correct APC assignment, status indicator coding, and packaging rules compliance directly impact outpatient revenue.
CMS Quality Payment Program
The umbrella framework under MACRA that includes both MIPS and Advanced Alternative Payment Models (APMs). APM participation offers a 5% Medicare bonus and exemption from MIPS reporting.
The Shift from Fee-for-Service to Value Is Already Here
CMS has committed to transitioning 100% of Traditional Medicare beneficiaries into accountable care relationships by 2030. ACO REACH, Medicare Shared Savings Program (MSSP), and Kidney Care Choices are among the current APM tracks already active. Participation in a qualifying APM exempts clinicians from MIPS reporting and provides a 5% Medicare Part B incentive payment.
Vizier tracks your quality performance under both fee-for-service and value-based frameworks simultaneously — modeling how your current clinical outcomes would translate into shared savings or shared losses under an ACO contract.
Detailed Guides and Analytics for Every US Program
2026 Complete MIPS Guide
The full methodology, measure selection strategy, scoring formula, and submission timeline for the 2026 MIPS performance year. 3,000+ words of practical guidance.
Read the Guide →MIPS Reporting Analytics
Real-time score tracking, benchmark comparison, penalty risk calculator, and MIPS Value Pathway modeling for clinical practices.
See MIPS Analytics →Readmission Prevention
HRRP penalty exposure calculation, LACE scoring, discharge planning gap analysis, and provider-level readmission rate comparison.
See Readmission Analytics →Revenue Cycle Optimization
E&M coding gap detection, denial root cause analysis, and payer performance benchmarking for US billing environments.
See RCM Analytics →FAQ
US Healthcare Analytics Questions
Which US regulatory programs does Vizier specifically support?+
Vizier supports MIPS/MACRA Quality Payment Program scoring, HRRP penalty projection, Hospital VBP scoring across four domains, IPPS DRG and case-mix optimization, OPPS APC accuracy, ACO/MSSP quality reporting (Web Interface and APP measures), Medicare Advantage Star Ratings, HEDIS performance, and Joint Commission ORYX core measures. Each program's measure logic is implemented per the CMS specification.
What is the 2026 MIPS performance year payment exposure?+
The MIPS payment adjustment for the 2026 performance year applies in CY 2028 and carries up to ±9% on every Medicare Part B claim. The performance threshold (avoid penalty) is 75 points; the exceptional performance threshold (additional bonus) is 89. A 1,000-provider group with $50M in Medicare receivables faces $4.5M in penalty exposure or upside depending on score.
How does Vizier handle the transition to value-based care?+
More than 60% of Medicare payments now flow through value-based arrangements — MSSP, REACH, Medicare Advantage, BPCI Advanced, and others. Vizier ingests attribution lists from each contract, tracks PMPM cost trends against benchmark, computes contract-specific quality measures, and projects shared-savings or downside-risk outcomes. The dashboard is contract-specific because the rules differ.
Does Vizier support state-level Medicaid quality reporting?+
Yes. Vizier supports CMS Adult and Child Medicaid Core Set measures, plus state-specific Medicaid quality reporting programs (Texas DSRIP/Quality Improvement Program, California Quality Incentive Pool, New York Delivery System Reform Incentive Payment, and others). State-level submission file formats are generated where applicable.
How does Vizier handle the 21st Century Cures Act information blocking provisions?+
Vizier consumes data from EHRs via the FHIR APIs mandated by the Cures Act and ONC's Final Rule on information blocking. Patient access to data (USCDI v3+) and provider-to-provider data exchange (TEFCA, Carequality) are supported where the source EHR is connected.
Does Vizier work across hospital, ambulatory, post-acute, and home health settings?+
Yes — each setting has its own measure set: IQR for hospitals, MIPS for clinicians, IRF-PAI for inpatient rehab, MDS for SNFs, OASIS for home health. Vizier supports the measure logic for each, and customers running multiple settings (e.g., a health system with hospital, employed-physician group, and home health subsidiary) see unified analytics with setting-appropriate views.
Built for the US Regulatory Environment
MIPS scoring, HRRP penalty modeling, ACO quality tracking, and revenue cycle analytics — designed for US health systems navigating the full complexity of CMS quality programs.