December 14, 2017

MedPAC Considers Voluntary Alternative to MIPS

At a Dec. 7 meeting, The Medicare Payment Advisory Commission (MedPAC) discussed draft recommendations that advise Congress to adopt a voluntary alternative to the Merit-based Incentive Payment System (MIPs) and to consider raising payment rates in 2019 for physicians and other health professionals, hospital inpatient and outpatient services, and ambulatory surgical centers.
MedPAC’s support for a proposed voluntary value program (VVP) reflects its belief that much of the information reported under MIPS is not meaningful and that scoring clinicians on different levels of effort is not equitable.

As covered in a draft recommendation from Commission Chair Francis J. Crosson, MD, the proposed VVP would maintain the value component of Medicare fee-for-service payments, eliminate mandatory clinician measure reporting to the Centers for Medicare & Medicaid Services and encourage physician participation in advanced alternative payment models (AAPMs). It would also center on a uniform, population-based and patient-surveyed set of measures to assess clinicians as groups, not as individuals.

Another draft recommendation advises Congress to increase the calendar year 2019 Medicare payment rates for physicians and other health professional services by the amount specified in current law.

Regarding hospital inpatient and outpatient services, MedPAC reported that costs continue to rise, causing Medicare margins to fall. Marginal profits, however, have increased eight percent, giving hospitals more incentive to accept Medicare patients. The chairman’s draft recommendation asks Congress to raise the payment rate for acute care hospitals by 1.25 percent, an increase that would represent no change in spending relative to current law.

MedPAC noted that Medicare beneficiaries had similar access to care compared to privately insured citizens. In terms of health care quality, the commissioners noted that low-value care is very common under Medicare, but that national rate of avoidable hospitalizations continues to decline.