MGMA18: Underwhelming MIPS payments leave physicians ‘feeling like it was just for nothing’

08 Oct 2018 | SOURCE: Fierce Healthcare

 

Doctor putting money in pocket

 

BOSTON—For all the work involved in the Merit-based Incentive Payment System (MIPS), the highest-scoring physicians ended up with a 2.02% payment adjustment, leaving them disheartened with the program.

Doctors who scored the maximum 100 points under MIPS received only a 2.02% positive payment adjustment, said Drew Voytal, associate director for government affairs for the Medical Group Management Association (MGMA).

For many physicians, “It’s a wash,” Voytal told an audience at the MGMA’s annual conference in Boston on Monday. “They are feeling like it was just for nothing.”

Physicians and physician practices had to report quality and other data to achieve high scores in the MIPS program, often investing in additional resources from personnel to technology.

The problem? In the first year of the program, CMS made reporting easier in its “transition year.” The program is supposed to be budget neutral so that doctors and practices that incur penalties for failure to participate or poor performance pay for the positive payment adjustments for those who score well. In 2017, the first year of the program, CMS estimated that 91% of eligible physicians participated in the payment program. That kept them from avoiding a penalty that would have resulted in a 4% cut in their Medicare reimbursement—money that would have funded incentive payments to others.

When all was said and done and the Centers for Medicare & Medicaid Services (CMS) released the 2017 final scores for physicians who participated in the Medicare payment program—payments that will be made in 2019—many were disappointed.

“Many people are just disheartened,” Voytal said.

Voytal urged physicians to log into CMS’ Quality Payment Program website to review their scores. In fact, CMS recently discovered it made mistakes calculating MIPS payments to some physicians and revised many scores. Physicians and practices who believe errors were made in their scores now have until Oct. 15 to request a targeted review by CMS.

MGMA officials said CMS’ feedback to physicians was also not sufficient and for some was inaccurate.

To stay on track with MIPS, physicians should take the following steps moving forward, Voytal recommended:

  • Assess your performance under past reporting programs to compare with how you are doing under MIPS.
  • Evaluate your vendor readiness and costs, including asking about the use of 2015 Edition Certified Electronic Health Record Technology, which CMS proposes to require next year.
  • Protect your practice against a MIPS penalty, including by failing to participate in the program if required.
  • Determine your 2018 MIPS goal and establish a reporting strategy for the data you are required to submit.
  • Comply with deadlines, such as those for submitting quality and other data.
    Analyze your data at year end to see how you are doing and where you can improve

CMS is currently reviewing more than 15,000 comments on a proposed rule issued in July that will outline changes for year three of the physician payment program implemented under MACRA.

CMS will issue a final rule this fall. One proposed change will allow doctors in small practices who don’t meet the existing threshold to participate in MIPS to opt in, allowing them to be eligible for bonus incentives.

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