Doctors Want to ‘Report’ for Duty

When was the last time you heard of professionals demanding the government let them take part in a reporting program? You would think most providers would clamor to be relieved of extra burdens.

But that’s the case with a quality measure program for doctors – and other medical professionals down the road – that started this year.

Doctors submit measures to the Medicare agency and their claims payments are adjusted up or down depending on how well they do. 

The Merit-based Incentive Payment System (MIPS) in 2017 exempted from reporting doctors with $30,000 or less in Medicare charges or who provide care to 100 or fewer beneficiaries during a performance period. 

Thinking it was sparing those with limited resources from taking on another task and possibly receiving cuts in their Medicare payments, the government proposed for 2018 to exempt those billing $90,000 or less or treating 200 or fewer beneficiaries. The number of doctors relieved from MIPS based on size is estimated to jump by the tens of thousands. 

But in comments due last week, doctor groups bombarded the Medicare agency with requests to permit their smaller-volume members to report if they so desire. Under current policy, such providers may voluntarily report, but they get no payment adjustment for doing so. 

The American Academy of Family Physicians was typical of those. The general practice group told the Centers of Medicare & Medicaid Services that it “adamantly demands” that the agency offer an “opt-in pathway” for practices otherwise prohibited from MIPS reporting. 

Many family practices are participating in the 2017 MIPS program and will want to participate in 2018, the academy said.

Also, moving practices in and out of MIPS sends mixed messages to physicians on whether they should further invest in practice transformation, the family docs added.

And, keeping the smaller practices out of the 2018 performance period, and then including them later, would put them at a significant disadvantage compared to practices that have experiences with reporting in 2017 and 2018. 

Medicare did say it’s considering easing up in the future on its prohibition of MIPS participation for smaller practices. It is considering whether to allow participation for small groups that meet just one of the two limits—either the charges or the number of beneficiaries.

However, the agency said the earliest this would happen is 2019 while doctors want this to occur ASAP.

The final rule will be out in a few months, at which point we’ll find out if the doctors’ entreaties bore fruit.

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