Today, the United States Centers for Medicare & Medicaid Services (CMS) published the Calendar Year 2027 Physician Fee Schedule Final Rule which finalizes inclusion of the American Heart Association (AHA) stewarded Low-Density Lipoprotein Cholesterol Monitoring and Management quality measure in the Merit-based Incentive Payment System (MIPS).
Title: Low-Density Lipoprotein Cholesterol (LDL-C) Monitoring & Management
- Steward: American Heart Association
- Program: MIPS
- Measure: Percentage of patients aged 18 years and older with clinical atherosclerotic cardiovascular disease (ASCVD) who received a LDL-C test via lipid panel and achieved an LDL-C of <70mg/dL on the most recent test during the measurement period.
- Effective Date: January 1, 2027
- Payment Adjustment: January 1, 2029
For nearly three years, the National Lipid Association (NLA) has been at the forefront advocating to return LDL-C measurement and management as the focus of LDL-C-related quality measurement. “Current CMS quality measures inappropriately focus on the prescription of statin medications in individuals living with clinical ASCVD regardless of whether lipid goals are being met or the medication is being taken as prescribed,” stated Dinesh Kalra, MD, FNLA, President of the NLA and chief of cardiovascular medicine in the Department of Medicine at University of Louisville School of Medicine. “This new MIPS measure is consistent with the 2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia and addresses clinically meaningful gaps in care for individuals living with ASCVD,” continued Dr. Kalra.
The measure will be implemented in Traditional MIPS and the Advancing Care for Heart Disease MIPS Value Pathway (MVP), beginning with the 2027 performance year with the first payment adjustment effective in the 2029 payment year. “The addition of the LDL-C Monitoring and Measurement measure in MIPS is a significant step towards providing systematic guideline-directed LDL-C goal achievement for ASCVD risk reduction,” stated Kaye-Eileen Willard, MD, FNLA, Immediate Past President of the NLA and Chief of Staff for Ascension All Saints.
The next important step is to bring awareness to the measure to support its selection and implementation. “Now the NLA and other organizational supporters need to advocate for clinicians, practices, and institutions that participate in MIPS to select this measure as one of six quality measures on which MIPS payment adjustment is determined,” added Brian Hart, JD, Executive Director of the National Lipid Association.
The NLA is committed to supporting the implementation of the LDL-C Monitoring & Management measure through resource development and dissemination while continuing to advocate for LDL-C measurement and management as part of the CMS Universal Foundation of Measures.