decisionhealth Newsletters, Part B News - 2019 Issue 9 (September)
As MIPS, practice hassles get harder, pay-for-performance gets more attractive
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Article Overview
This article examines the growing operational and financial pressures surrounding Medicare’s Merit-based Incentive Payment System and related value-based care initiatives. It is relevant to physicians, practice managers, and healthcare organizations that follow Medicare payment policy, practice administration, and the broader shift away from traditional fee-for-service arrangements. The discussion touches on program performance trends, proposed changes, industry feedback, tax considerations, and the movement toward alternative payment models.
Why This Topic Matters
The article helps readers understand why some practices may find MIPS increasingly burdensome and how Medicare policy changes may affect practice strategy, financial planning, and participation in alternative payment models.
Article Sections
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MIPS performance trends and rising program pressure
This section reviews published MIPS performance results and explains how participation requirements and payment pressure are changing over time. It provides context for the program’s expanding role in Medicare payment policy.
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Low bonuses persist
This section discusses the limited financial upside associated with program participation and the compliance burden faced by practices. It also notes broader considerations related to incentive payments and taxation.
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No tax relief in sight
This section addresses how recent tax law changes may affect physicians and practices. It focuses on the broader financial environment rather than the MIPS program itself.
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Next stop: Value-based care
This section looks at practice consolidation, administrative stressors, and the shift toward alternative payment arrangements. It also discusses Medicare’s direction toward value-based models and related participation trends.
What You Will Learn
- How MIPS fits into the broader Medicare payment landscape
- Why practices may view compliance and administrative burdens as increasingly significant
- What kinds of policy and market pressures are encouraging movement toward alternative payment models
- How tax and practice-management issues can intersect with payment program participation
Who Should Read This
- Physicians
- Practice managers
- Healthcare administrators
- Medical group executives
- Healthcare reimbursement and compliance professionals
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