CMS proposed sunsetting traditional MIPS starting in 2029. Before the eulogies, look at the program's own data: half a million clinician score records from the latest public QPP file, in one distribution. It's a quality program where nearly everyone gets an A — and the punishment concentrates on the smallest practices. Step through the four chapters below; the chart morphs to tell each one.
What this chart can't tell you: ① One bar-unit here is a TIN/NPI record, not a person — a clinician billing under two organizations appears twice, and CMS publishes no clean dedup key. ② This is PY2024 data, released after the performance year; it is not a real-time scorecard. ③ A score of 87 is built from measures clinicians chose to report — the distribution measures documentation capacity at least as much as care quality. The +0.4% adjustment is reporters only; including non-reporters brings the record-level average to +0.24%. That's the actual indictment: a signal this saturated can't tell a good clinician from a good billing department, which is why CMS is replacing it.
The builder read: every registry, dashboard, and eCQM vendor built for this curve now has a 2029 countdown clock. The replacement — MVPs, ACO reporting, outcome-tied software payment — is being specced in public, in a comment period, right now. Nobody sane starts new construction on traditional MIPS today.