Forty-nine physician groups have asked the government to reduce the reporting period for MIPS this year.
In a letter (PDF) to the Centers for Medicare & Medicaid Services (CMS), the groups, which represent hundreds of thousands of doctors, asked that the period for reporting quality measures be cut from a full year to a minimum of 90 days for 2018. The groups requested the change because CMS did not post information about which doctors must participate under the Merit-based Incentive Payment System (MIPS) until April 6.
CMS is requiring physicians to report quality data for a full 365 days in the second year of the MIPS program that began Jan. 1.
The medical associations, groups and societies that issued the letter, which include the American Medical Association, the country’s largest physician organization, say that’s unfair due to the CMS’ failure to inform physicians of their MIPS eligibility status at the start of the year. “We are concerned with physicians’ ability to satisfactorily participate in the MIPS program due to the late notification,” the groups wrote.
Last year, to give physicians a chance to get up to speed on the new Medicare payment system, doctors had to report quality data for only 90 days to be eligible for an incentive payment. That was changed to a full 365 days for 2018.
The groups also cited CMS’ delay in updating the Quality Payment Program interactive website with 2018 MIPS information as another reason to cut the reporting period. The agency does not plan to update the site with 2018 information and measures until the summer, they said.
Additionally, the groups hope CMS will reduce the reporting period for future years in order to reduce administrative burden on doctors and ensure they have sufficient time to report quality measures after receiving performance feedback from the agency.
.@MGMA @AmerMedicalAssn @aafp @AANSNeuro & 45 physician orgs call on @CMSGov to reduce #MIPS quality reporting period from 365 to 90 days so physician practices can spend less time reporting and more time focused on #patient care. #PatientsOverPaperwork https://t.co/wA1zHx0NQy— Anders Gilberg (@AndersGilberg) April 19, 2018
CMS did not release information that enables clinicians to determine whether they must participate in MIPS this year until earlier this month despite the fact that physician groups had appealed to the agency back in January to release the critical information on whether they were in or out of the program. Given new low-volume threshold requirements that make small practices that treat a small number of Medicare patients ineligible, CMS has estimated that more than 500,000 clinicians will be excluded from MIPS this year.
The letter follows on the heels of a new study that found serious flaws with many of the MIPS performance measures. Researchers of the study, published in the New England Journal of Medicine, called for a “time out” in the use of performance measures for physicians after finding that less than 40% of the metrics are valid. The researchers assessed the quality measures against criteria for validity devised by the American College of Physicians.
"What we should be paying for in a value-based system is higher-quality care,” the study’s lead author, Catherine H. MacLean, M.D., Ph.D., of the Hospital for Special Surgery in New York, said in an announcement. "It's critically important that we have the right measures. A bad measure is a missed opportunity to inform clinical care.”
That research adds to criticism of the MIPS payment system. Critics have called for delays or a total scrapping of MIPS, including the Medicare Payment Advisory Commission (MedPAC), which voted in January to recommend to Congress that it replace MIPS because the payment system is flawed. MedPAC said MIPS is costly to physician practices and won’t lead to higher quality care.