The Medicare Payment Advisory Commission (MedPAC), a nonpartisan legislative branch agency that provides analysis and policy advice about Medicare to Congress, recently released a proposal to repeal and replace the Merit-based Incentive Payment System (MIPS).
Members of MedPAC have argued that MIPS leads to administrative burden and does not establish clear financial incentives for delivering high quality care. Issues raised in the draft recommendation include the tendency for MIPS participants to only choose measures for which they are high-performers and the prioritization of process measures over outcomes measures.
MedPAC is proposing to introduce the Voluntary Value Program (VVP) in place of MIPS. This program would compare physicians to their peers on certain performance-based quality of care measures. These measures would be reported solely through Medicare claims submissions, which would eliminate use of data reporting options such as Qualified Clinical Data Registries (QCDRs) and Certified EHR Technologies (CEHRTs).
Under the proposed VVP, physicians who have comparably higher scores on certain measures would receive incentive payments, and physicians who do not participate in any Alternative Payment Model (APM) would have a percentage of their Medicare revenue withheld. MedPAC is still considering specific measures to use in the program as well as the percentage of revenue to withhold for nonparticipation.
This draft recommendation will be voted on by the entire MedPAC in January 2018. If approved, the Commission will include it in its annual report to Congress in March and request immediate action to repeal and replace MIPS.