On Jan. 11 the Medicare Payment Advisory Commission (MedPAC), an independent congressional agency charged with advising Congress on issues affecting Medicare, voted 14-2 to recommend that Congress eliminate the Merit-based Incentive Payment System (MIPS).

MIPS was established through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has been in effect since Jan. 1, 2017. It is designed to improve care by providing payment adjustments to eligible clinicians who report practice-specific quality data.

However, some stakeholders have judged MIPS to increase administrative burden and to be overly focused on process measures rather than patient outcomes. MedPAC has proposed to replace MIPS with the Voluntary Value Program (VVP), which would involve an across-the-board withhold of all fee schedule payments.

Under the VVP, clinicians who participate in an Advanced Alterative Payment Model (APM) would receive the withheld amount. Clinicians who enter into a group and report on population-based measures related to quality, patient experience, and value also would be eligible for an incentive payment on top of the withheld amount.

The MedPAC vote outcome suggests strong disapproval of MIPS; yet, several MedPAC members who voted to get rid of MIPS also criticized the proposed VVP. Commissioner Kathy Buto, MPA, for example, voted in favor but expressed concern that the VVP would not be able to control for economic disparities.

MedPAC’s request to eliminate MIPS will be included in its March report to Congress. For information about MIPS, visit the MACRA page on the AASM site or contact coding@aasm.org.