MedPAC Sinks MIPS, Recommends Alternative Program
Commission votes 14-2 to fold Merit-based Incentive Payment System.
This article first appeared January 11, 2018 on Medpage Today.
By Shannon Firth
WASHINGTON -- The Medicare Payment Advisory Commission (MedPAC) voted 14-2 to in favor of killing the Merit-based Incentive Payment System (MIPS) and replacing it with an alternative model of reimbursement on Thursday.
While the numbers appear to signal a strong consensus for the proposed recommendations, a handful of members who voted to nix the program expressed hesitation.
"I'm not afraid to make an unpopular decision, but I want to make sure we do something constructive," that sends the right message and is headed in "the right direction," said Commissioner Warner Thomas, of Ochsner Health System in New Orleans.
Thomas worried that if commissioners aren't careful, the alternative model -- the Voluntary Value Program -- meant to replace the MIPS could repeat some of its mistakes.
Commissioner Kathy Buto, MPA, of Arlington, Virginia, said that after listening to her colleagues, she wasn't "totally comfortable" with the VVP. She noted that the recommendations should focus on "uncertainties" such as what percentage should be withheld for fee schedule payments, and how to control for economic disparities.
But as was pointed out by Commissioner Dana Gelb Safran, ScD, of Blue Cross Blue Shield of Massachusetts in Boston, who also voted in support of the recommendations, "I don't hear a single commissioner saying we must preserve MIPS."
On the other hand, the panel had previously ruled out a straight "repeal" of MIPS. The decision was between two models: MIPS and the VVP.
MIPS combines parts of the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier, and Meaningful Use into one single program based on quality, resource use, and clinical practice improvement. Under MIPS, doctors earn a payment adjustment based on evidence-based and practice-specific quality data that they report to the Centers for Medicare & Medicaid Services (CMS).