MIPS Takes a Beating at MedPAC

MedPage Today, October 6, 2017

MedPAC has been set on defeating the Merit-based Incentive Payment System for a long time; but whether the program should be simply "repealed" or "repealed and replaced" wasn't clear at Thursday's meeting.

This article first appeared October 01, 2017 on Medpage Today.

By Shannon Firth

WASHINGTON -- Health policy experts sometimes battle for consensus over payment issues, but when it comes to the new way of paying most doctors under Medicare, one group reached near-unanimous agreement: Scrap it.

The Merit-based Incentive Payment System (MIPS) should be spiked, virtually all members of the Medicare Payment Advisory Commission (MedPAC) said during a meeting on Thursday morning.

MedPAC, whose members include physicians, healthcare executives, and other policy experts charged with advising the Department of Health and Human Services on Medicare policy issues, has been set on defeating MIPS for a long time; but whether the program should be simply "repealed" or "repealed and replaced" wasn't clear at Thursday's meeting.

At the start of the meeting, MedPAC's analysts addressed the challenges with the MIPS program and proposed a potential alternative.

The Problem with MIPS

The MIPS program is one of two payment vehicles created as a result of the the Medicare Access and CHIP Reauthorization Act (MACRA) -- which replaced the almost universally despised Sustainable Growth Rate (SGR) formula. The other payment pathway consists of an array of advanced Alternative Payment Models (APMs), which weren't discussed in any detail at the meeting.

The main problem with the MIPS program, as MedPAC's analysts see it, is that MIPS won't achieve the policy goals that it's designed to achieve.

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