- The Medicare Payment Advisory Commission (MedPAC) finalized its recommendation to repeal the Merit-based Incentive Payments System (MIPS) payment track under MACRA at its regular meeting Thursday, Modern Healthcare reported.
- Commissioners also discussed a recommendation of increasing hospital Medicare rates by 1.25% for FY19. The draft recommendation includes a freeze in Medicare payment updates for ambulatory surgical centers, skilled nursing facilities and long-term care hospitals, according to commentary from Cowen Washington Research Group.
- MedPAC said hospitals’ access to capital is strong and the quality of care is improving. A presentation prepared for the meeting said hospital occupancy rates remain low, and outpatient use is increasing while inpatient use drops.
MedPAC has gotten pushback for urging the repeal of MIPS, but many providers remain unprepared for MACRA payment changes and think the law is too complex and has a high reporting burden. MedPAC said clinician reporting burden in 2017 cost more than $1 billion.
Earlier this month, the American Hospital Association (AHA) urged the commission to “use data and experience from the field before advocating for major changes to the MIPS.”
The replacement for MIPS that MedPAC is recommending would withhold about 2% of payments for physicians not in an alternative payment model. Those that continue in a fee-for-service model would forfeit the payments. Those that choose to join a new payment model would have a chance at recovering the withheld amount.
The modest increase in hospital Medicare payments is in line with current law. It estimates a market basket update of 2.8% and accounts for a 0.8% productivity adjustment and an ACA adjustment of 0.75%. MedPAC will issue its final guidance on rates at its January meeting.
The commission’s recommendations don’t have any legislative authority. The group exists to offer analysis and guidance to Congress. Last year, MedPAC recommended a hospital payment increase of 1.85% and CMS finalized an increase of 1.2%.