A break for doctors: Trump administration wants to reduce reporting burden under MIPS

A doctor sitting at his desk working on a laptop computer.
Under the proposal, physicians would see reporting burdens reduced or eliminated, as CMS would assess performance without requiring clinicians to report information, leaving more time for providers to focus on patient care. (Getty/monkeybusinessimages)

Doctors could get a break from the burden of quality reporting under MIPS if President Donald Trump's budget proposal for the 2019 fiscal year is approved.

The Trump administration's budget (PDF) proposes to end quality reporting under the Merit-based Incentive Payment System, one of two tracks under Medicare’s new payment system implemented by the Medicare Access and CHIP Reauthorization Act (MACRA).

Under the proposal, physicians would see reporting burdens reduced or eliminated, as the Centers for Medicare & Medicaid Services would assess performance without requiring clinicians to report information, leaving more time for providers to focus on patient care.

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A summary (PDF) of the proposed budget for the Department of Health and Human Services makes changes to MACRA. Effective in 2021, the budget calls for the removal of two performance categories under MIPS and only evaluating performance based on “meaningful quality and cost measures.”

The proposal simplifies MIPS by adopting broader claims and beneficiary survey-calculated measures that assess performance on quality and cost during the performance period at the group level only. Payment adjustments will apply only to payments made under the Physician Fee Schedule rather than to all payments made under Medicare Part B.

As for the other track under MACRA, Advanced Alternative Payment Models, the budget proposal removes the thresholds that clinicians must meet to receive a bonus for participating and instead rewards all clinicians who take part in them.

The MACRA changes included in the budget proposal drew a mixed response, according to an article by the Healthcare Financial Management Association. Some praised the proposal as a way to reduce or eliminate quality reporting requirements. But the HFMA article said others doubted CMS’ ability to assess performance using internal data alone.

RELATED: MedPAC votes to replace MIPS, but physician groups not ready to abandon new payment system

The proposal does reflect the concerns from the Medicare Payment Advisory Commission (MedPAC), which voted last month to recommend that Congress replace MIPS with a new voluntary value program. MedPAC said MIPS is costly to physician practices and won’t lead to higher quality care.

However, as much as they dislike aspects of it, two major physician groups both disagreed with the proposal to replace MIPS, a payment system that’s been in place for just over a year. Instead, the American Medical Association and the Medical Group Management Association want to work to fix the existing program.

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