MedPAC Votes to Replace MIPS

January 16, 2018


On Thursday, January 11, 2018, the Medicare Payment Advisory Commission (MedPAC) recommended eliminating the Merit-based Incentive Payment System (MIPS) and its related reporting requirements and replacing it with a voluntary value program. Under the proposed model, all clinicians would have a portion of their fee schedule payment withheld. Clinicians then could earn the withhold back by joining a voluntary group and electing to be assessed on a uniform set of population-based measures for quality, patient experience and value, or by joining an Advanced Alternative Payment Model (APM). Clinicians doing neither would lose the withhold.

The Commissioners believe MIPS, in its current form, is flawed and burdensome.  The Commissioners believe that Advanced APMs have much greater promise in meeting Medicare policy goals of improving quality and reducing costs, and that the proposed voluntary value program would better prepare and incentivize clinicians to participate in Advanced APMs.

A number of provider groups acknowledge problems with MIPS, but do not support terminating the program, including the Medical Group Management Association, the American Hospital Association and the Alliance of Specialty Medicine. Some stakeholders have raised concerns that not all clinicians would have the opportunity to join a voluntary group and be measured as part of a large entity or join an Advanced APM and as a result they will lose their withhold. Two commissioners voted against the recommendation.

Slides from the January 11 MedPAC meeting are available here.

More information on MedPAC is available here.

For more information visit the McDermottPlus MACRA Resource Center or contact Sheila Madhani at 202-204-1459,

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