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which included severe drops in the volume of patient visits. It also prevented physicians from being unfairly penalized for services associated with caring for patients diagnosed with COVID-19 during the pandemic.
More transparency, relevancy needed
While financial relief measures offer short-term mitigation, advocacy efforts are also in progress that are part of an effort to make improvements to the system that will have long-term benefits.
This includes advocating for increased transparency in how cost measures are developed. Earlier this spring, the AMA and nearly 50 other physician organizations called on CMS to release the cost-measure benchmarks it used in 2018– 2020.
“Because the benchmarks have not been published, physicians cannot compare their spending to the target in the current performance period or prior periods, nor can they determine whether the benchmarks are fair and valid, accounting for variations in resource use that are within a physician’s control,” the organizations said in a letter to acting CMS Administrator Elizabeth Richter.
CMS has agreed to release those files. The AMA
will closely review the files to identify the target spending for those years, how the benchmarks capture any variations in spending, and whether the benchmarks are leading to fair and valid comparisons among physicians.
The AMA is also urging CMS to alter its approach to the MIPS Value Pathway (MVP) program, moving it away from siloed categories and pivoting toward a holistic, condition-focused approach with a clear goal
of improving patient outcomes. The AMA joined 41 national specialty societies in recommending reforms the agency could make.
MIPS’ $12,811 tab
The need to reform MIPS was made clear in a pair of recent studies funded by the AMA and the Physicians Foundation Center for the Study of Physician Practice and Leadership at Weill Cornell Medicine.
Practices spent an average of $12,811 per physician to participate in MIPS in 2019, according to “Time and Financial Costs for Physician Practices to Participate in the Medicare Merit-based Incentive Payment System,” a qualitative study published in JAMA Health Forum.
Physicians, clinical staff and administrative staff together spent more than 200 hours annually per physician on MIPS-related activities. Physician time accounted for 54% of overall MIPS-related costs and averaged $6,909.
On average, physicians spent more than 53 hours a year on MIPS-related tasks. Those hours could provide care for an extra 212 patients a year, researchers estimated.
In the other study, researchers reported on the views held by the 30 practice leaders who were interviewed. Those finding were listed in a recent Journal of General Internal Medicine study. Practice leaders were conflicted on whether MIPS improves care, said it creates a big administrative burden made worse by annual changes, and that incentives are small compared with the effort need to take part.
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