06 Sep MACRA at Ten: What a Decade of MIPS Performance Data Says About Physician Payment Adjustments
When Congress passed the Medicare Access and CHIP Reauthorization Act in 2015, it promised to fix something almost everyone in medicine hated: the Sustainable Growth Rate formula. SGR had a habit of threatening double-digit payment cuts to physicians almost every year, only for Congress to patch it at the last minute. MACRA killed that formula for good. In its place, it built a new system meant to tie Medicare Part B payments to performance rather than volume. That system, the Merit-based Incentive Payment System, started collecting real performance data in 2017. Physicians are now heading into roughly a decade of MIPS reporting history. That's long enough to ask a fair question: did the program do what it was supposed to do? According to CMS, MIPS is designed to shift Medicare payments from volume-based to value-based reimbursement, with adjustments applied to Medicare Part B claims two years after the performance period based on composite scores across four weighted categories.
[caption id="attachment_75901" align="aligncenter" width="500"] Photo by Vitaly Gariev[/caption]