Under the Medicare Access and CHIP Reauthorization Act, practices participating in the Merit-based Incentive Payment System (MIPS) can receive a payment adjustment for successful implementation of quality improvement, electronic health record adoption, and performance. The adjustment based on a clinician’s performance in 2017 impacts the clinician's Medicare reimbursement for 2019.
Practices in the US Oncology Network received an average positive payment adjustment of 1.90% for performance in 2017, and 99% of the Network’s physicians were in the top tier of performers. The maximum allowable adjustment is 2.02%.
“MIPS can be a complex and onerous program for a practice,” Marcus Neubauer, MD, chief medical officer for the US Oncology Network, said in a statement
. “By working closely with the value-based care team, practices in the Network received the support and tools needed to manage the MIPS requirements. Together, we were able to achieve great results.”
, CMS Administration Seema Verma announced that 91% of all clinicians eligible for MIPS participated in the first year of the program. However, MIPS has not been without controversy. The American College of Physicians (ACP) called for CMS
to halt MIPS and reassess the approach to evaluating physician performance.
ACP had analyzed1
86 performance measures in MIPS and the Quality Payment Program and found that 32 (37%) were valid, 30 (35%) were not valid, and 24 (28%) were of uncertain validity. In addition, 19 measures were judged to have insufficient evidence to support them.
Earlier in the year, the Medicare Payment Advisory Commission (MedPAC) recommended repealing and replacing MIPS in favor of a Voluntary Payment Program, in which 2% of clinicians' payment would be withheld if they were not enrolled in an advanced alternative payment model or chose to be evaluated on certain population-based measures.
Like ACP, MedPAC has also raised questions about the meaningfulness of the quality outcomes measures recommended under MIPS.
MacLean CH, Kerr EA, Qaseem A. Time out—charting a path for improving performance measurement. N Engl J Med.