MIPS Repeal: What do I do now?

The Medicare Payment Advisory Commission (MedPac) the commission that advises Congress on payment policies for Medicare and Medicaid has voted 14-2 to repeal and replace MIPS. It was designed to improve patient care and outcomes by consolidating existing quality programs with financial incentives for Providers.


They claim that the system just implemented would not provide the desired results as it is too cumbersome and the system could be “gamed”. Providers have the option of reporting individually or as a group. Groups depending on their size can spread the results around hitting their numbers essentially protecting poor performers and earning a bonus that they wouldn’t earn if they reported individually.


Many providers have slammed this vote as they say that they are just beginning to understand the requirements, Many Physicians feel that fully implementing the plan will change healthcare delivery as we know it as finally financial incentives will be aligned. This has been a long standing issue in healthcare as financial success is based on volume. In the new system 60% of your potential financial return will be based on Quality.


In order to be compliant every practice needs a robust electronic medical record system. In addition to maintaining patient information it is the only way you can extract the necessary data and submit it through your system or a registry to CMS. On average it costs $32,409 per physician in the first 60 days and an additional $7,000 for hardware. If your practice doesn’t have the support you will need to hire additional FTE(s) based on the size of your practice at an average cost of $50,000 per year.


Now that you have spent all of this money had training and begun collecting data MedPac decides to try and change the rules. The major concern that I and many others have is that MedPac has offered no alternative plan to replace MIPs, Furthermore, MedPac staff explained that a repeal would not occur until 2019 or 2020 if Congress approves their recommendation. What do I do now? You continue to participate and receive additional revenue or maintain your reimbursement level and wait and see what happens. As we all know 1-2 years is an eternity in healthcare changes.