The CMS is considering unveiling a new web tool that helps clinicians assess the potential impact of merit-based incentive payment systems (MIPS) on their reimbursement. It will also help them evaluate their performance under the system and provide tips to improve scores. The tool could help ease concerns about the risk undertaken in the new payment models.
Under MIPS, which were mandated under the Medicare Access and CHIP Reauthorization Act, physician payments will be based on a compilation of quality measures and the use of electronic health records.
Physicians could also choose to participate in an alternative payment model like an accountable care organization to meet MACRA requirements.
The idea of a new web-based tool came from HHS' Advisory Panel on Outreach and Education (APOE), which is a panel on promoting the agency's programs.
Deena Chisolm, a member and associate professor of pediatrics and public health at Ohio State University suggested the tool could help practices choose between a MIP and APM.
On Wednesday, the agency said it would create one, although no timeline was given for when it would be available. The agency said it was determining what data to pull to ensure accuracy.
Once doctors formally begin to report under MIPs, the agency believes the tool can give clinicians personalized feedback.
The tool should make it easier for individual providers to improve performance and for provider executives to set their strategy under MACRA, Rivka Friedman, practice manager, research at the Advisory Board said in response to the news.
Chet Speed, vice president of public policy at American Medical Group Association said the tool should help small practices without strong technology.
Others are more skeptical. One concern is that actual performance data won't be available until 18 months after a physician sees a patient.
Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association said that would provide only a "theoretical estimate."
Some worry that such a tool could be 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 and co-founder of the single-payer advocacy group Physicians for a National Health Program.
Himmelstein also argues that the tool will divert doctors' focus from caring for patients to caring for the documentation.
The CMS has been concerned that the new value-based payment payment system could drive doctors away from Medicare participation.
There is evidence of an uptick in the number of physicians dropping out of government programs because of the increased administrative burden, even though the overall participation in Medicare remains high.
So far this year, a total of 19,543 physicians aren't participating in Medicare, according to federal data. That's up from 3,700 in 2009.
At the APOE meeting Wednesday, the CMS said it would track regional Medicare clinician participation and termination from Medicare and assess what may be causing departures should they begin to occur. It will also assess the impact on access to care in that area.
