A key Medicare player in the nation’s capital is ready to see Congress blow up the Merit-Based Incentive Payment System (MIPS) just one year after its launch.
On Thursday, the Medicare Payment Advisory Commission (MedPAC) voted 14-2 to recommend that Congress eliminate MIPS and replace it with an alternative quality program known as the Voluntary Value Program, according to multiple reports. MedPAC provides Congress with analysis and policy recommendations on Medicare.
MIPS was one of the central pieces of the Medicare Access and CHIP Reauthorization Act (MACRA), the 2015 bill that repealed the much-maligned Sustainable Growth Rate payment formula. Physicians who participate in MACRA’s Quality Payment Program do so through one of two tracks: MIPS or an alternative payment model.
The law didn’t go into effect until the beginning of 2017, but it didn’t take long for MIPS to draw criticism from many physicians and from MedPAC, which spent the final months of last year discussing a potential replacement option.
According to MedPage Today, under MedPAC’s proposed Voluntary Value Program, clinicians would see a set percentage of their fee schedule money withheld. They could earn it back by either participating in an advanced alternative payment model or by joining a voluntary group, which would be evaluated on “population-based measures related to clinical quality, patient experience, and value.”
MEDPAC Chair Francis Crosson, MD, said the commission had spent a lot of time evaluating MIPS, according to MedPage Today. “We came to the conclusion that it’s simply not fixable,” he said.
The American Medical Association (AMA) on Thursday recommended simplifying MIPS rather than killing it altogether.
"The AMA agrees that MIPS needs to be simplified and has methodological issues that are problematic for physicians," AMA President David O. Barbe, MD, said in a statement. "The best remedy is to fix MIPS rather than jumping into another sweeping change that has not been fleshed out and would have many of the same methodological issues as MIPS."
Barbe urged federal lawmakers to pass a proposal, created in part by TMA, that would give CMS more time and flexibility to address issues with the program.
Texas Medicine is keeping an eye on MACRA action in Washington and will update you when new developments emerge.