Will there be an end to MU's pass/fail system?

Will there be an end to MU’s pass/fail system?

In an effort to reach the goals of paying for better care and effectively engaging patients in its programs, the Centers for Medicare and Medicaid Services recently rolled out a new Merit-Based Incentive Payment System as one of its two methods, according to the government agency. The MIPS, as well as a second Alternative Payment Models initiative, is slated to begin later this year and last well into the next several years.

What is the MIPS?
Bringing together the Physician Quality Reporting System, Value-Based Payment Modifier and meaningful use incentive program, the new payment system will essentially streamline current performance standards, according to the Advance Healthcare Network newsletter. The performance-based system of payment aims to improve the quality of care and lower costs. Going forward with this payment plan, providers who perform well will be remunerated and those who do not perform high enough will face the consequences, according to the health care newsletter. Four new means of measuring performance will include quality, resource use, clinical practice improvement and compliance with quality reporting measures.

What will it take?
As the agency begins to integrate the meaningful use portion of the new payment model, it turned to industry stakeholders for information and feedback. The success of the new Merit-Based Incentive Payment System won't happen overnight. The College of Healthcare Information Management Executives believes that in order to achieve a smooth and effective transition to the new payment system, the CMS needs to alter reporting systems and employ simpler methods for meaningful use, according to HealthData Management. In fact, in a recent letter to the agency, the CHIME called upon the CMS to eliminate the pass/fail system for meaningful use altogether. 

"CHIME strongly supports creating a pathway for MU whereby physicians are moved to a more flexible regulatory model and away from a 'pass/fail' construct. The same pathway must also be created for hospitals," the letter stated. "Additionally, the complexities associated with quality reporting should be reduced to bring the value intended under new models of care."

Currently, performance calculations require that 100 percent achievement of MU measures have been reached. The CHIME has recommended that this benchmark be reduced to 75 percent and that by moving those that are eligible to a single set of standards, it would eliminate the need for the pass/fail structure currently in place, according to Health Data Management. The organization has also suggested that specific data measurements, reporting tactics and other repetitive and burdensome measures be eradicated to ensure a successful outcome for MIPS.