MIPS: Can I Ignore or Avoid It?

Leigh Page

Disclosures

July 07, 2016

In This Article

Choosing Not to Participate in MIPS

Clinicians who don't expect to earn any MIPS bonuses may simply decide not to participate in all or part of MIPS, says Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association. He notes that some practices do this already under the current reporting programs.

These practices view not participating as "strictly a return on investment (ROI) calculation," he says. That is, they might decide that even the full 4% maximum penalty in 2019 is less costly than having to reorganize their practices to comply with MIPS in 2017.

Gilberg acknowledges that when the maximum penalty under MIPS rises to 9% in 2022, the ROI calculation changes significantly. The practice might then be forced to buy the infrastructure that it had been putting off.

There is another downside besides penalties for low performance in MIPS: Low-performing clinicians will see their MIPS scores published on the Physician Compare website, which began posting Physician Quality Reporting System scores in 2016. John Peabody, MD, PhD, president of QURE Healthcare, a San Francisco-based company that measures clinical quality of practices, says more consumers are relying on such postings. He points to a 2014 study[1]finding that two thirds of patients are aware of online assessments of physicians, which researchers said was a much higher rate than in earlier surveys.

Some physicians may be waiting for MIPS to just go away, but how likely is that? "It's not going to happen," says Jonathan Burroughs, MD, a consultant in North Conway, New Hampshire, who has been helping physicians transition to the new system.

Although Republicans constantly vow to repeal the Affordable Care Act if they got into office, the Congressional GOP actually had a hand in drafting the Medicare Access and CHIP Reauthorization Act of 2015, and the law passed the Senate by a 92-8 margin, according to Dr Lee.

MIPS will evolve as its penalties and bonuses become more meaningful to physicians, Dr Peabody says. "CMS will probably modify the MIPS measurements to make sure they are impactful and fair," he says.

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