ASTRO, together with more than 30 physician organizations, sent a letter to the Centers for Medicare and Medicaid Services (CMS) outlining areas to improve quality, patient outcomes and efficiencies in the Merit-based Incentive Payment System (MIPS) Value Pathway (MVP) program. The letter urges CMS to align MVP with Alternative Payment Models, reduce burdens for MVP participants and ensure MVPs remain voluntary. The letter also suggests CMS prioritize MVP by condition, episode of care and clinical priority areas, not just by specialty. ASTRO continues to monitor proposed changes to the MVP program, as well as all Medicare quality programs.