On November 1, the Centers for Medicare & Medicaid Services (CMS) released its 2025 final rule for the Medicare physician fee schedule impacting the Quality Payment Program. Phreesia’s Patient Activation Measure® (PAM) performance measure (PAM-PM), which was already a key part of the program, was added to additional Merit-based Incentive Payment System (MIPS) specialty sets and MIPS Value Pathways (MVPs) in 2025.
Phreesia, a leader in patient activation, proudly stewards the PAM-PM which measures the change in a patient’s knowledge, skills, and confidence to manage their own healthcare over a twelve-month period via a brief 10 or 13 item survey.
Patient activation is a patient’s knowledge, skills and confidence to manage their own health and healthcare. Lower activation has been shown to be predictive of poor self-management, worse outcomes, and higher costs across all populations. But activation is not a fixed trait, rather all patients can gain in activation when appropriately supported. The PAM is backed up by over 800 peer-reviewed studies demonstrating its efficacy to predict health-related behaviors, clinical and mental health outcomes, treatment satisfaction across numerous patient populations and chronic diseases, and reduce healthcare costs.
PAM-PM was initially added to MIPS in 2024 and CMS noted then that “…this measure is a “broadly applicable” and “high priority” quality measure that “ensures capture of the patient voice and experience of care related to the patient’s understanding and confidence in the ability to manage their health and be an active partner in their health care journey.” PAM is now included in 21 specialty sets and 10 MVPs.
PAM-PM IN MIPS 2025
MIPS Specialty Measure Sets
- Allergy/Immunology
- Cardiology
- Certified Nurse Midwife
- Clinical Social Work
- Dermatology
- Endocrinology
- Family Medicine
- Gastroenterology
- Geriatrics
- Infectious Disease
- Internal Medicine
- Nephrology
- Neurology
- Obstetrics/Gynecology
- Oncology/Hematology
- Physical/Occupational Therapy
- Podiatry
- Preventive Medicine
- Pulmonology
- Rheumatology
- Urology
MVPs
- Complete Ophthalmologic Care
- Dermatological Care
- Gastroenterology Care
- Obstetrics/Gynecology
- Optimal Care for Patients with Urologic Conditions
- Oncology/Hematology
- Physical/Occupational Therapy
- Podiatry
- Preventive Medicine
- Pulmonology
- Pulmonology Care
- Rheumatology
- Urology
The PAM-PM has been part of the Centers for Medicare & Medicaid Services Innovation Center (CMMI) Kidney Care Choices (KCC) program since 2022. It is one of the first Patient Reported Outcome Performance Measures (PRO-PMs) to be implemented in an alternative payment program. Notably, an evaluation of the first-year results from KCC shows remarkable results. Eighty-five percent of large KCC-participating healthcare organizations successfully implemented interventions to address the needs of less-activated patients, and patients gained on average 9 points on the 100-point PAM scale.
In the KCC model, providers were incentivized to support gains in activation, in a highly diverse technological and resourced ecosystem, resulting in clinically meaningful gains across all patient populations, including dual eligibles as highlighted in this Health Affairs article.
“Although PRO-PMs are relatively new, the first-year KCC results drove clinically meaningful results for activation among all patients across small and large practices alike, with varying degrees of technology and staffing resources. MIPS-participating clinicians face similar diversity in patient mix and technological and staffing resources. Those are not barriers to success on the measure. MIPs-participating clinicians can support their patients to make similar gains in activation while concurrently improving their MIPS performance scores. We look forward to partnering with MIPs-participating clinicians to implement PAM-PM and to activate their patients while supporting their successful participation in MIPs.”
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