Radiologists demand greater transparency from CMS in Merit-Based Incentive Payment System
Radiologists are among dozens of physician groups demanding greater transparency from the federal government in its administration of the Merit-Based Incentive Payment System.
The Centers for Medicare & Medicaid Services recently granted hardship relief for clinicians in the quality payment program, due to the COVID-19 pandemic. Groups including the American College of Radiology and Society of Interventional Radiology thanked CMS for that lifesaver but are urging the agency to go further in helping docs navigate MIPS.
In an April 13 letter to the acting head of CMS, physicians asked the feds to “immediately” release benchmark data from 2018-2020, and provide real-time, rolling updates from the current measurement year.
“We are very concerned that CMS has never published MIPS cost measure benchmarks, despite using these metrics to evaluate physician and group performance in the MIPS Cost Performance Category,” ACR, the American Medical Association and numerous others wrote to Administrator Elizabeth Richter. “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 physician groups are “particularly concerned” that the dearth of data could be concealing issues with cost measures or benchmarks. They worry that measures might be capturing “little variation in spending” among the quality program, leading to rads and other docs being penalized for “merely one outlier case.”
“We would also like to understand the impact of the COVID-19 [public health emergency] on the cost measures, including the benchmarks, and cannot make this assessment without this vital information,” they added.
Finally, the groups also want CMS to release quality measure benchmarks at least 30 days prior to the start of the performance period. They’re asking the agency to “hold harmless” physicians by moving to pay-for-reporting when significant updates to benchmarks are made during the performance period.
You can read the entire letter from the 45 physician groups here. The American College of Radiology alerted its members about the request in a new update published Wednesday, April 21.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.