MIPS: Stall or Snuff?


The first week in October was a bad one for MIPs, the 10-month-old quality reporting program that many medical professionals have to—or eventually will have to—follow to avoid Medicare payment cuts.

The week started out with an Oct. 2 letter from 115 medical groups asking congressional leaders to slow down full MIPS implementation. They asked that some provisions of Medicare’s Merit-based Incentive Payment System be implemented more slowly over the next few years than contemplated.

MIPS is a major part of a 2015 law that governs how Medicare pays medical professionals. Those not participating in certain alternative payment models have to report quality data measures under MIPS to avoid a cut.

On Oct. 4, American Medical Association President David O. Barbe, a family doctor from Missouri, came to Washington and emphasized to reporters that many of his peers may not be ready for certain provisions to kick in. He told us the Medicare agency should be given more flexibility to put the requirements in place “at a pace that makes more sense.”

Things got worse for MIPS the next day. A discussion on the doctor quality reporting program topped the Oct. 5 meeting agenda of the Medicare Payment Advisory Commission, which advises Congress on Medicare policy. Medicare’s congressional advisers want more than to just take a nip out of MIPS. They want the whole system gone.

The commissioners say MIPS is complex, a burden on doctors, and will not achieve the goal of rewarding high-value clinicians. The measures themselves are not associated with high-value care, they say.

MedPAC has yet to put forth recommendations to Congress on MIPS. But even when it does, the likelihood that Congress will get rid of MIPS, which took effect Jan. 1, is much less than certain. It took years—and many “doc fixes”—before Congress replaced the infamous sustainable growth rate (SGR) formula that led to double-digit reductions in Medicare reimbursements. Congress’ appetite for more deliberations on the topic of Medicare doctor payments may be satiated.

Read my full story on the MedPAC meeting here.

Stay on top of new developments in health law and regulation with a free trial to the Health Law Resource Center.

Learn more about Bloomberg Law and sign up for a free trial.