February 08, 2018

Share:

  • LinkedIn
  • Twitter
  • Facebook
  • Email

The Medicare Payment Advisory Commission recently voted to replace the Merit-Based Incentive Payments System (MIPS), leaving many health care leaders questioning their current payment strategies. During our recent webinar “What’s Happening with MIPS? A Policy Update from Caravan Health”, senior vice president of strategy and development Tim Gronniger brought clarity around the proposed changes and discussed how hospitals can best position themselves for success with MIPS.

Gronniger shared that this January, MedPAC – a Medicare advisory body for congress – voted in their annual March report to eliminate the MIPS program and replace it with a new Voluntary Value Program (VVP).

In their recommendation, MedPAC expressed criticized MIPS for being excessively burdensome, encouraging measures that aren’t meaningful for patients, and not creating strong enough incentives to join alternative payment models like ACOs.

To overcome these challenges, MedPAC proposed the VVP replace MIPS with the following:

  • Withhold 2 percent of Medicare payments for providers not in APMs
  • Clinicians not joining the VPP forfeit the 2 percent withhold
  • Non-APM clinicians reclaim a portion of the withhold by participating in a voluntary group that would be measured on a set of population-based measures
  • Measures would be claims-based

Gronngier noted that the VVP has received less than favorable reactions from Congress, and that Commission members are also in disagreement over the proposal. The group expressed concerns that the option will encourage clinicians to remain in fee-for-service, the 2 percent margin won’t encourage behavior change, and that claims-based measures ignore case mix and socioeconomics.

While the MedPAC vote remains uncertain, Gronniger shared that Congress will most likely take action on other, much more limited modifications of the MIPS program.

Based on those proposed elements, Gronniger said that Medicare extenders will be added, as well as a “MACRA extender” package that provides limited additional authority for CMS to relax thresholds for now, and exclusion of Part B Drugs from MIPS adjustments.

No matter what the future holds for MIPS, Gronniger stands firm that ACO participation is the most favorable and sustainable payment strategy for hospitals. Congress has favored risk-bearing payment models for the long term, and participating in an ACO now will provide the easiest path to participating in a risk-bearing model in the future.

To learn more, watch the webinar.

Recent Articles and News

March 27, 2020

Managing the COVID-19 Crisis: Stop the Risk Clock for ACOs

Health care providers nationwide are responding heroically to the crisis of the COVID-19 pandemic. The virus is spreading, and our providers are on the front lines managing and treating more patients each day. Caravan Health calls on CMS to assure that the Medicare Shared Savings Program will fairly account for these extraordinary circumstances.

ACO, News, Policy, CMS

March 26, 2020

COVID-19: Primary Care Strategies to Support Alternative Care Delivery Methods

On March 20, Dr. Anna Loengard, Chief Medical Officer of Caravan Health hosted a video webinar and addressed the impact of COVID-19 on primary care including planning, prevention, patient management, and virtual care options.

ACO, News, Policy, CMS

March 16, 2020

COVID-19: A Summary of Emergency Government Funding and Medicare Telehealth Options

In response to the fast-moving global health emergency caused by COVID-19, Congress has approved $8.3 billion in emergency supplemental funding. The aid will help federal agencies prepare to manage and contain the spread of this highly contagious respiratory illness. In addition to providing funds for preparedness and response activities, the new law makes it easier for Medicare providers to evaluate their patients remotely during this national health emergency.

ACO, News, Policy, CMS

COVID attention

Early bird registration is now open for the 2020 Virtual Accountable Care Symposium.

ACO insights delivered right to you

Thank you

Sign up for our newsletter of data-driven news and stories from the latest in ACOs, value-based care, and population health.

  • Real-time insight into alternative payment model trends
  • Strategies and practices that drive results
  • Leadership lessons from health care and beyond
  • Perspectives on the changing health care landscape

By sharing your email you agree to our Privacy Policy

newsletter signup