Advisory Group Recommends Simplifying MIPS Reporting Requirements
Improvements to the Merit-based Incentive Payment System (MIPS) are needed to reduce administrative burden and increase emphasis on positive patient health outcomes, according to the June report from the Medicare Payment Advisory Commission (MedPAC).
The report included a detailed proposal for how to improve the MIPS program. “MIPS as presently designed is unlikely to help beneficiaries choose clinicians, help clinicians change practice patterns to improve value, or help the Medicare program reward clinicians based on value,” according to the report. “In part, this result is likely because the MIPS quality category is designed to allow clinicians to choose six measures from a large set of process measures, and if they choose measures that are ‘topped out’ (measures on which everyone performs well), they will have high absolute scores,” the authors wrote. The commission noted that currently MIPS does not differentiate between high and low performing practices, and also raised issue with the fact that most of the 275 quality measures in MIPS do not directly address the measurement of patient health outcomes.
The three possible options to further policy discussions outlined in the report include:
- An alternative design could eliminate reporting burden and create incentives for clinicians to move to high-value models
- A modification of the five percent advanced alternative payment model (A-APM) incentive payment could simplify the system and increase equity by applying the five percent A-APM incentive payment only to clinicians’ revenue through the A-APM
- The MIPS exceptional performance bonus fund could be used to finance support for A-APMs to address the disparity in attractiveness of MIPS versus A-APMs
The report suggests more population-based outcome measures and relying more on claims data and survey results instead of physician reporting. “The benefits of using population-based measures are significant,” the authors wrote. “This approach sends clinicians a signal that they should view the care they provide as part of a continuum that crosses sectors and incorporates the totality of patient care.”
To read the full report, click here.
MedPAC is an independent nonpartisan congressional agency established to provide the US Congress with analysis and advice on issues affecting the Medicare program. Other topics discussed in the report include implementing a unified payment system for post-acute care, Medicare Part B drug payment policy issues, using premium support in Medicare, and an overview of the medical device industry.
Sarah Sheber is assistant editor/web editor at Journal of AHIMA.