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Verma Says MIPS Numbers Beat First-Year Goals

Allison Inserro
CMS reported that 91% of all clinicians eligible for the Merit-based Incentive Payment System (MIPS) participated in the first year of the Quality Payment Program (QPP), surpassing the agency’s goal of 90%.
CMS reported that 91% of all clinicians eligible for the Merit-based Incentive Payment System (MIPS) participated in the first year of the Quality Payment Program (QPP), surpassing the agency’s goal of 90%. Administrator Seema Verma said submission rates for accountable care organizations and clinicians in rural practices were at 98% and 94%, respectively.

Under QPP, doctors must enroll in 1 of 2 reimbursement tracks—MIPS or Advanced Alternative Payment Model (A-APM)—under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

The program is not favored by providers. In April, the American College of Physicians (ACP) called for a "time out" to assess and revise the approach to assessment of physician performance, saying the majority of quality measures for ambulatory internal medicine are not valid.

And in January, the Medicare Payment Advisory Commission (MedPAC) conducted a formal vote and recommended repealing and replacing MIPS with a Voluntary Value Program (VVP), where 2% of clinicians' payment would be withheld if they were not enrolled in an A-APM or chose to be evaluated in certain population-based measures.

Reporting on the quality measures required by CMS in order to receive the highest payment possible under QPP requires monitoring of 4 performance categories: quality, improvement activities, advancing care Information, and cost.

In an email to The American Journal of Managed Care®, ACP said it wanted more detailed information from CMS about the first year of the MIPS program.

“We would like to know the breakdown of penalties and bonuses, by specialty type and practice size. We'd like know the actual dollar amount of incentives that were paid,” said Shari Erickson, vice president, Governmental and Regulatory Affairs, ACP. “We'd like to know how many of the physicians who did participate reported only 1 measure, as allowed by the pick-your-pace option to avoid a penalty. The high-level participation data is a start, but we hope there is much more information from CMS to come."

In a blog post, Verma said CMS is “committed to removing more of the regulatory burdens that get in the way of doctors and other clinicians spending time with their patients.” She wrote that CMS has reviewed many of the MIPS requirements in order to “reduce burden, add flexibility, and help clinicians spend less time on unnecessary requirements and more time with patients.”

She cited reducing the number of clinicians that are required to participate; adding new bonus points for clinicians who are in small practices, treat complex patients, or use 2015 Edition Certified Electronic Health Record Technology exclusively as a means of promoting the interoperability of health information; and gradually phasing in implementation of certain requirements for 3 more years.

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