New Payment Model for Docs
Our government, via the CMS, has released a draft on how it would support a new payment model. It is called the Quality Measure Development Plan and it is beautiful. The new Merit-based Incentive Payment System (MIPS) is for providers who choose to participate in alternative payment models (APMs). You got that? MIPS and APMS. Now these MIPS and APMs replaced the Medicare Access and CHIP Reauthorization Act of 2015 or what is called the MACRA.The MACRA effectively sunsets payment adjustments for three existing clinician reporting and incentive programs—Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Meaningful Use Electronic Health Record Incentive Program for eligible professionals. You still with me? Let me continue with exact wording from the plan:
The PQRS, VM, and EHR Incentive Program programs have each played an important role in the early development of physician-based quality measurement and reporting in the Medicare program but to reduce provider burden, CMS seeks to optimize efficiencies through greater alignment across these programs.
The draft Quality Measure Development Plan released on Friday by CMS focuses on gaps identified in the quality measure sets currently in use in PQRS, VM and Meaningful Use, offering recommendations for filling these gaps.
To fill identified measure and performance gap areas, CMS will expand and enhance existing measures to promote alignment and harmonization in the selection of measures and specifications, while concurrently developing new (de novo) measures.
According to CMS, starting in 2019 the agency will apply a positive, negative, or neutral payment adjustment to each MIPS eligible professional based on a composite performance score across four performance categories: quality, resource use, clinical practice improvement activities, and meaningful use of certified EHR technology.
Is this crystal clear to you?
I have a new payment model that I think would work better. It is actually an old model. It is called CASH. Opt out of this crap like I did and take CASH. No more MIPS, APMs, MACRA, PQRS, VM, MU, EHRIP. There is no proof this stuff works. My only quality indicator is whether patients feel I am doing a good job for them. If I don’t then they leave and I don’t get any more of their CASH. That model has worked for all civilizations since humans have been on this planet. I think I will continue it.
I opted out of medicare and all insurance plans 10 years ago and have never been happier with my practice!
You should be a role model for the rest.
Don’t worry:
According to CMS, starting in 2019 the agency will apply a positive, negative, or neutral payment adjustment to each MIPS eligible professional based on a composite performance score across four performance categories: quality, resource use, clinical practice improvement activities, and meaningful use of certified EHR technology.
Sooo….it COULD be a way to pay doctors more. Right?
On a second note, shout out to the AMA and the various Boards for a terrific job at taking over the role of command – Physician Individual Merit Performance Scale. Thanks, sugardaddies! I’m a-shakin’ it!
The Care Available Supportive Home, or CASH-model is evidence-based with centuries of data confirming its quality effectiveness, and efficient resource usage. Further empiric data has overwhelmingly shown that participation in Medicare, Medicaid, and a host of “private” plans degrade from the primary care physician the essential qualities of Competence, Affability, Sincerity, and Humor, so necessary for the CASH model.
Well said.
I’d like a job working for CMS coming up with silly convoluted payment structures for physicians.
There’s no call.