By Cindy Tomlinson, ASTRO Senior Patient Safety and Regulatory Affairs Manager
The Medicare Payment Advisory Commission (MedPAC), the independent congressional agency that advises Congress on issues affecting the Medicare program, believes that the Merit-based Incentive Payment System (MIPS) is too burdensome on clinicians and should be replaced before clinicians become too entrenched in the program. Despite the recommendation, ASTRO continues urging radiation oncologists to participate in the MIPS program, which is current law, to avoid penalties and potentially earn bonus payments.
MedPAC makes policy recommendations, but does not have the authority to set payment policy. While Congress is considering some technical changes to the MIPS program this year, it is highly unlikely that Congress will repeal MIPS in 2018 and may not act on MedPAC’s recommendations at all.
At their January meeting, the Commission voted to recommend that Congress eliminate MIPS. As a replacement, MedPAC recommends establishing a new voluntary value program (VVP) in which clinicians can elect to be measured as part of a voluntary group, therefore qualifying for a value payment based on their group’s performance on a set of population-based measures.
The proposed VVP would maintain a value component in traditional fee for service, aligned with other value-based purchasing programs in Medicare. It would also serve as a gateway to prepare clinicians to participate in Advanced Alternative Payment Models (APMs). After a withhold is applied to all fee schedule payments, clinicians can elect to:
Voluntary group performance will be assessed using uniform population-based measures in the categories of clinical quality, patient experience and value. MedPAC believes that the new program would significantly reduce clinician burden, while not affecting beneficiaries’ access to care. As with the current MIPS program, some providers would see a reduction in payment, while others would see an increase.
As with many things, the devil is in the details, and a full report—with more details on the VVP—is due to Congress in March.
While ASTRO has strongly urged CMS to reduce the complexity and burden of the MIPS program, radiation oncologists already have invested significant resources in MIPS participation after shifting over from MIPS predecessor quality initiatives. There is concern about another dramatic shift from MIPS to the VVP. What do ASTRO members think? Is it time to ditch MIPS or pursue changes to make it workable while progressing toward an APM?
In the meantime, please be sure to check out our educational resources including information on MIPS, the Radiation Oncology APM, and the Quality Oncology Practice Initiative (QOPI®) Reporting Registry, brought to you by American Society for Clinical Oncology (ASCO) and ASTRO, which can help with the increased reporting requirements for the 2018 MIPS program.
The Medicare Payment Advisory Commission (MedPAC), the independent congressional agency that advises Congress on issues affecting the Medicare program, believes that the Merit-based Incentive Payment System (MIPS) is too burdensome on clinicians and should be replaced before clinicians become too entrenched in the program. Despite the recommendation, ASTRO continues urging radiation oncologists to participate in the MIPS program, which is current law, to avoid penalties and potentially earn bonus payments.
MedPAC makes policy recommendations, but does not have the authority to set payment policy. While Congress is considering some technical changes to the MIPS program this year, it is highly unlikely that Congress will repeal MIPS in 2018 and may not act on MedPAC’s recommendations at all.
At their January meeting, the Commission voted to recommend that Congress eliminate MIPS. As a replacement, MedPAC recommends establishing a new voluntary value program (VVP) in which clinicians can elect to be measured as part of a voluntary group, therefore qualifying for a value payment based on their group’s performance on a set of population-based measures.
The proposed VVP would maintain a value component in traditional fee for service, aligned with other value-based purchasing programs in Medicare. It would also serve as a gateway to prepare clinicians to participate in Advanced Alternative Payment Models (APMs). After a withhold is applied to all fee schedule payments, clinicians can elect to:
- join a voluntary group and have their performance assessed at the voluntary group level;
- join an Advanced APM, and receive the withhold back; or
- make no election and lose the withhold.
Voluntary group performance will be assessed using uniform population-based measures in the categories of clinical quality, patient experience and value. MedPAC believes that the new program would significantly reduce clinician burden, while not affecting beneficiaries’ access to care. As with the current MIPS program, some providers would see a reduction in payment, while others would see an increase.
As with many things, the devil is in the details, and a full report—with more details on the VVP—is due to Congress in March.
While ASTRO has strongly urged CMS to reduce the complexity and burden of the MIPS program, radiation oncologists already have invested significant resources in MIPS participation after shifting over from MIPS predecessor quality initiatives. There is concern about another dramatic shift from MIPS to the VVP. What do ASTRO members think? Is it time to ditch MIPS or pursue changes to make it workable while progressing toward an APM?
In the meantime, please be sure to check out our educational resources including information on MIPS, the Radiation Oncology APM, and the Quality Oncology Practice Initiative (QOPI®) Reporting Registry, brought to you by American Society for Clinical Oncology (ASCO) and ASTRO, which can help with the increased reporting requirements for the 2018 MIPS program.