While Medicare’s Merit-Based Incentive Payment System "is well-intentioned", the program has started to undercut small and rural practices, a blog post from the American Medical Association said.
Born out of the 2016 Medicare Access and CHIP Reauthorization Act, the policy aims to create a value-based healthcare system that incentivizes physicians to focus on successful patient outcomes and quality of care, rather than completing a larger amount of clinical tasks.
Eighty-seven percent of MIPS-eligible clinicians received a bonus or avoided penalties in 2022, affecting payments in 2024, according to the AMA. However, small and rural practices made up a disproportionate amount of the remaining 13% of eligible physicians.
According to CMS’s 2022 Quality Payment Program Experience Report, 27% of small physicians practices and 18% of rural ones were penalized. Almost 30% of physicians in solo practice received the maximum 9% penalty, and anesthesiology and orthopedic surgery were among the most heavily penalized specialties.
Research by the JAMA Network points to further flaws in MIPS, including scores that are inconsistent with performance, the high burden of required paperwork and the program's tendency to exacerbate existing health disparities.