Quick action urged if MedPAC wants to move ahead with MIPS replacement

Doctor putting money in pocket
MedPAC commissioners were told to move ahead quickly if they want to move ahead and recommend scrapping MIPS. (Getty/Niyazz)

If the Medicare Payment Advisory Commission (MedPAC) wants to replace the current Medicare payment system for physicians, they should move ahead quickly with that recommendation.

At a meeting this week, MedPAC staff told commission members to take action before physicians become entrenched in the Merit-Based Incentive Payment System (MIPS), which began this year. In a presentation (PDF) to MedPAC commissioners, staff called MIPS “burdensome and inequitable.”

“The time for action is now before there is an established constituency of clinicians getting very high positive adjustments,” MedPAC staff member Kate Bloniarz told the commissioners in the presentation. MedPAC serves an advisory role to Congress on Medicare matters.

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Most of the MedPAC commissioners agreed with staff members’ recommendation to replace MIPS with a new proposal, with only one commissioner expressing hesitation, according to MedPage Today.

In October, almost of all the MedPAC members said MIPS should be replaced after staff proposed the development of an alternative payment system. However, replacing MIPS may not be easy, as Kate Goodrich, M.D., the Centers for Medicare & Medicaid Services’ chief medical officer, said much of the proposal would require statutory changes that would need Congressional approval. 

MedPAC staff have put forth a plan to replace MIPS with a program called the voluntary value program. At this week’s meeting, MedPage Today reported that commissioner Alice Coombs, M.D., expressed reservations about scrapping MIPS as she fears it could push more physicians to become hospital employees so they don’t have to worry about complying with the replacement program.

The debate over the value of MIPS has gained steam in recent months. Two recent studies have also raised concerns about the future success of MIPS. Researchers found Medicare’s Value-Based Payment Modifier Program, the predecessor of MIPS, failed to meet its goals and likely exacerbated disparities in healthcare delivery. A separate study released this week found that almost 30% of practices took a financial penalty that cut their Medicare revenue rather than participate in the program.

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