Surveyors Question Doctors’ Reporting Under Medicare Pay Program


To report or not to report—that is the question.

It was posed to 1,000 doctors, with a number of other questions, about quality reporting under Medicare’s new physician payment system.

What level of reporting is your practice planning to do in 2017?


What is your reason for not reporting?

Those were among the questions that the American Medical Association and KPMG LLP, the national audit, tax and advisory firm this spring asked doctors who have been involved in practice decision-making about the new Medicare quality payment program.

The surveyors wanted to find out about their level of preparation and participation in the reporting track of the payment program, called the Merit-based Incentive Payment System or MIPS, which began Jan. 1.

Under MIPS, payment rates for physicians and other eligible health-care professionals will be cut or raised depending on how they’re scored on quality measures.

The Medicare agency gave clinicians the choice of how to report under MIPS. They could do so for a full 90 consecutive days and earn the chance for bonuses of up to 10 percent; submit partial data and earn a slight bonus; or do the minimum and avoid a penalty by reporting one measure but earn no extra money.

Those who don’t participate in the quality program at all will have their payments cut.

The results were the centerpiece of a conference presentation I attended in Arlington, Va., last week.

Here’s what was revealed:

A third of physicians who expect to participate in MIPS this year plan to do the bare minimum required to avoid a penalty. On the opposite end of the spectrum, another third plan to opt for full reporting in 2017.

There was a mix of other responses for the remainder. Eight percent told surveyors they don’t expect to participate in the quality payment program period and another 12 percent didn’t know whether or how to participate this year.

Like anything new, it’ll take time to iron out problems.

The surveyors found that respondents faced their share of challenges, among them: Understanding reporting requirements, understanding the MIPS scoring process, and the cost to accurately capture and report performance data. But the most significant problem, doctors said, was the time it took to do the reporting.

Read my full story 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.