Medicare advisory panel discusses alternative to MIPS

At a recent meeting, the Medicare Payment Advisory Commission (MedPAC) discussed an alternative policy to replace the Merit-based Incentive Payment System (MIPS) in order to reduce provider burden. MedPAC is an organization which advises CMS on Medicare policy issues.

In their presentation, MedPAC senior analyst Kate Bloniarz and principal policy analyst David Glass stated that MIPS places a significant burden on clinicians, with over $1 billion as the 2017 estimated reporting burden reported by CMS.  

The presenters found MIPS to be extremely complex for providers, with its multiple reporting options, measures, and scoring rules. Bloniarz and Glass state that the current policy would not be sustainable in detecting high- or low-value clinicians. Some of the scoring concerns listed include:

• Ability for clinicians to choose their own measures, resulting in incomparable MIPS scores across clinicians
• Process measures which aren’t associated with high-value care
• Statistical limitations

Bloniarz and Glass propose creating a voluntary value program, which would eliminate MIPS reporting requirements. Two percent of payments would be withheld for providers not partaking in an alternative payment model (APM). These providers would then be eligible to receive a portion of that money back after receiving a CMS evaluation on performance-based measures along with a related group of providers. The proposed solution would include claims-based measures, so CMS could gather data instead of requiring provider reporting. According to their presentation, the goal is to help Medicare manage funding based on population-based outcomes, revealing individual clinician performance.