
MedPAC Votes a Resounding "No" to MIPS, Recommends Voluntary Value Program
The Medicare Payment Advisory Commission (MedPAC) conducted a formal vote that recommend repealing and replacing CMS’ Merit-based Incentive Payment System (MIPS).
The Medicare Payment Advisory Commission (MedPAC) conducted a formal vote that recommend repealing and replacing CMS’ Merit-based Incentive Payment System (MIPS), 1 of 2 reimbursement tracks that physicians can enroll in under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
With a 14-2 vote, the committee called for MIPS to be replaced with a Voluntary Value Program (VVP), where 2% of clinicians' payment would be withheld if they were not enrolled in an advanced alternative payment model (A-APM) or chose to be evaluated on certain population-based measures.
In their
The presentation states that the inequitable, burdensome system of MIPS “will not improve care for beneficiaries nor move the Medicare program and clinicians towards high-value care.”
Researchers have voiced concerns about how MIPS is structured, with an
Scoring for physicians in the MIPS track placed a higher weightage (60%) on care quality for 2017, while cost was at 0%. However, this was expected to shift by 2019, with each measure given a 30% weightage. Providers had the option of waiving participation in 2017, but would lose 4% of their payment for the year, which could be avoided by reporting on at least 1 of the 4 metrics.
MedPAC members want a complete elimination of MIPS, however, and they recommend replacing it with VVP, which, according to the presentation, would encourage movement toward A-APMs and eliminate clinical measure reporting. The committee shared the following key points about the new structure:
- Population-based, claims-calculated, and patient-surveyed measures
- Voluntary groups of physicians would be large enough to support population measures
- Value payment would be based on voluntary group performance
The claims-based tracking by CMS would eliminate concerns over physician reporting bias. Similar to MIPS, however, physicians who choose not to participate in any APM would be penalized by having a percentage of their Medicare payments withheld.
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