Led by the Texas delegation, the American Medical Association House of Delegates on Tuesday rejected as inadequate a plan to improve Medicare’s Quality Payment Program (QPP) and its highly-flawed Merit-Based Incentive Payment System (MIPS) track.
“Quite simply, this program is not working,” Beaumont anesthesiologist Ray Callas, MD, told delegates. “Now entering its fourth year, it has not been proven to improve quality or reduce costs, but it has been proven to harm physicians in solo and small practices nationwide. And this report does not commit our AMA to fight for the structural and operational changes that are needed to fix it.”
The house voted unanimously to send the report back to the AMA Board of Trustees for more work.
The report was the board’s response to resolutions submitted over the two previous meetings of the house by the Texas, Pennsylvania, and Florida delegations. Those resolutions asked AMA to advocate for very specific changes that would relax the financial and paperwork burden that MIPS and QPP impose on practicing physicians.
The Texas resolution, submitted in June of this year, called on AMA to:
- “Strongly advocate” that Congress make QPP participation “completely voluntary” for physicians;
- “Strongly advocate” for Congress to eliminate the budget-neutrality provision of the QPP so all Medicare bonuses for high performers are no longer paid for by penalties and cuts to physicians who don’t score as well;
- Call on the Center for Medicare & Medicaid Services (CMS) to publish a “transparent, accurate, and complete” annual report on the QPP; and
- Push CMS to increase the number or dollar amount of Medicare services a physician must provide before being required to participate in the QPP.
TMA physician leaders and staff complained that the AMA report glossed over most of those requests, and its only substantive provision was a lukewarm directive to support legislation that “supplements budget neutrality” rather than eliminate it and do away with payment penalties.
“The report does state that our AMA supports changes that would allow small practices to ‘succeed’ in MIPS,” Dr. Callas said. “But you can't succeed in MIPS and get a bonus unless another practice fails and pays a penalty. Budget neutrality undermines practice viability, demoralizes us, and threatens access to care.”
As they wait for a new report – likely to come in June 2020 – TMA, AMA, and many other state associations and national specialty societies will continue to fight for MIPS reform. “Physicians need relief now,” Dr. Callas added.
Find out more about TMA’s QPP advocacy activities and educational resources on the TMA website.