CMS unveils new MIPS 'framework' aimed at reducing reporting burden 

Photo of doctor and patient hands while discussing medical records after health examination
The Centers for Medicare & Medicaid Services has proposed an overhaul of the Merit-based Incentive Payment System. (andrei_r/GettyImages)

The Trump administration has proposed updates to the Merit-based Incentive Payment System (MIPS) it says would ease the quality reporting burdens in the program. 

The Centers for Medicare & Medicaid Services (CMS) introduced a new framework for MIPS called MIPS Value Pathways (MVPs) with the goal of making it easier for physicians to participate in the program. 

Under MVPs, the agency would move MIPS beginning in 2021 to a system in which clinicians are asked to report on a smaller set of measures that would be based on specialty and outcomes and are more aligned with new alternative payment models. 

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“Clinicians are drowning in paperwork and reporting requirements caused by cumbersome government rules and regulations,” CMS Administrator Seema Verma said in a statement. “These administrative costs add to the total cost of delivering healthcare, which means physicians often have to hire extra staff and spend more time complying with requirements instead of with their patients.” 

RELATED: 4 changes physician groups don’t like in proposed MACRA, physician fee schedule rule 

The changes are proposed in the annual Physician Fee Schedule and Quality Payment Program rule (PDF), which would, if finalized, be implemented in plan year 2020. MIPS was established under the Medicare Access and CHIP Reauthorization Act, or MACRA. 

The reporting requirements under MIPS have drawn ire from physician groups

Verma said on a call with reporters Monday that the updated model will allow providers to select measure sets that are applicable to the service lines relevant to their areas of focus. For example, an internal medicine physician could select a diabetes measure set, which would include “super measures” that go across all of the categories within MIPS, she said. 

“Clinicians can now report on fewer, more meaningful measures that are aligned to their specialty or practice area,” Verma said. 

The administrator added that CMS wants feedback from the clinical community on these changes and ways to expand on them, so stakeholders can “build a better program together.” 

RELATED: Medicare payments won’t cover costs for may physician practices in 2019, poll finds 

Additional changes proposed in the rule include codifying changes to payment rates for evaluation and management (E/M) services. CMS intends to adopt values proposed by the American Medical Association RVS Update Committee for these services. 

With these changes, physicians will be paid more for E/M services under Medicare, Verma said. 

In addition, the rule includes provisions to pay physicians more for care management services. Under the proposal, docs would be paid for care management services provided to patients with just one high-risk condition, such as diabetes. 

Verma said the change is likely to make it easier for patients to receive such services.  

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