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ACOs score high on MIPS, but low on payment adjustment

Payment adjustments are expected to range from 0.4 to 2.6 percent of providers' Part B expenditures, report says

Susan Morse, Senior Editor

New analysis shows Track 1 ACOs are likely to score well above the merit-based incentive system performance threshold and will receive positive MIPS payment adjustment.

However, the payment adjustments will be relatively small, ranging from 0.4 to 2.6 percent of providers' Part B expenditures, according to the report from the National Association of Accountable Care Organizations.

This is due to the relative ease of earning MIPS payment adjustments along with budgetary restraints of the budget neutral program, according to the report by NAACOS and Dobson | DaVanzo & Associates in Virginia.

[Also: AMA president weighs the pros and cons of MACRA, MIPS]

In August, the Department of Health and Human Services found that Medicare ACOs improved performance on 82 percent of individual quality measures and outperformed fee-for-service providers on 81 percent of quality measures, NAACO said.

But last week, the Medicare Payment Advisory Commission, made up predominantly of physicians, came out with a recommendation to Congress to scrap the MIPS program.

MIPS is too burdensome and complex and the reward minimal, MedPAC said. The system is designed to maximize clinician scores and is not a good measure of performance, MedPAC said.

Low performance standards combined with high scores will result in minimal rewards in the early years, with big payment swings later, the advisory board to Congress said.

MedPAC instead recommends a voluntary program with performance measures comparable to those in the advanced alternative payment model.

MIPS and APMs came out of the Medicare Access and CHIP Reauthorization Act as a quality payment model for clinicians.

Twitter: @SusanJMorse
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