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Medicare Access And CHIP Reauthorization Act

The Centers for Medicare & Medicaid Services is planning to launch a new tool to help clinicians assess the potential impact of Merit Based Incentive Program (MIPS) on their reimbursement. The tool is also aimed to help them evaluate their performance under the system and offer tips to improve their scores. Report say that the tool can also help to ease the concerns about risks that are undertaken in the new payment model.

MIPS was mandated under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and under that, physician payments were based on many quality measures and their efficient use of electronic records. Physicians also have the option to take part in Alternative Payment Models like Accountable Care Organization to meet the requirements of MACRA.

The idea of the web-based tool came from Advisory Panel on Outreach and Education (APOE) of HHS that is promoting the programs of the agency. Deena Chislom, a member and associate professor of pediatrics and public health at the Ohio State University, told the media that the tool could help different practices choose between APM and MIPS. However, CMS said that it will make the tool, but added that they were deciding on the data to be pulled for it to ensure accuracy.

The agency believes that the tool will be able to offer personalized feedback to clinicians once doctors formally start to report under MIPS. Rivka Friedman, research practice manager at the Advisory Board, said that the tool will help individual providers improve their performance and assist executives to set strategies under MACRA.

Chet Speed, vice president of public policy at the American Medical Group Association, said that the web tool would help smaller practices that do not have access to strong technology. However, many other experts are skeptical about the tool, and one of the major concerns is that the actual performance data will not be available until eighteen months after a doctor sees a patient.

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Advisory Panel On Outreach And Education

Senior vice president of government affairs at Medical Group Management Association, Anders Gilberg, said that the new tool by CMS would offer only a theoretical estimate. On the other hand, some of the concerns are about the tool being abused. “This move amounts to releasing a crib sheet that will help doctors game the MIPS payment system, the medical equivalent of teaching to the test,” said Dr. David Himmelstein, professor of public health, City University of New York at Hunter College.

CMS reported that around 19,543 physicians did not participated in Medicare so far in this year. The agency further said that they would track regional clinician participation as well as termination from Medicare and resolve the issues soon.

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