What’s the news: As part of its campaign to fix the unsustainable Medicare physician payment system, the AMA is outlining in a quick, easily navigable fashion the policy changes needed to remove obstacles to the successful use of clinical data registries in the program.
The AMA’s two-page explainer on clinical data registries in the transition to value-based care (PDF) outlines how the process of approving clinical data registries under the Merit-based Incentive Payment System (MIPS) is “complex and cumbersome,” and details how “the lack of accessible cost data inhibits progress toward true value-based care.”
This flawed approach means that “physicians’ ability to leverage their participation in these quality improvement efforts for MIPS and engage in continuous learning has been limited.”
Learn about how you can take part in the fight to fix Medicare on behalf of your patients and practices at the AMA's Fix Medicare Now website.
Leading the charge to reform Medicare pay is the first pillar of the AMA Recovery Plan for America’s Physicians.
The AMA has challenged Congress to work on systemic reforms and make Medicare work better for you and your patients. Our work will continue, fighting tirelessly against future cuts—and against all barriers to patient care.
Why it’s important: Clinical data registries provide timely feedback to participating clinicians on patient outcomes and the quality of care they provide to patients. The dynamic feedback provided by registries allows physicians to identify weaknesses and implement changes—often in real time—that create high-value care and track improvements over time.
But physicians who practice in larger institutions have little control over decisions about quality measure selection or about participation in a clinical data registry, which is known as a “qualified clinical data registry” within MIPS. Because of that, many of these registries and their measures are underused. In addition, the Centers for Medicare & Medicaid Services (CMS) takes a flawed approach to measuring the health IT-focused “Promoting Interoperability” component in MIPS that prohibits physicians’ use of innovative information technology that can move medicine forward.
“Well-designed clinical data registries, with access to claims data, incorporate all the elements of value-based care under MIPS: quality, cost, health information technology, and improvement activities,” the AMA explains, noting that CMS has failed “to recognize their overarching benefits.”
To fix this element of the unsustainable Medicare physician payment system, Congress should:
- Require CMS to grant automatic credit for requirements in the “Promoting Interoperability” and “Improvement Activities” MIPS categories for physicians or practices that participate in a clinical data registry.
- Instruct CMS to consider encouraging the use of innovative technology and clinical data registries in establishing standards for all MIPS categories and activities.
In addition, a physician or practice should also be able to satisfy the requirement to meet the “Promoting Interoperability” category in MIPS by attesting to using certified EHR technology or interacting technology products such as a laboratory or radiology information system, participation in a clinical data registry, or by other less burdensome means.
Learn more: The AMA has declared Medicare physician payment reform to be an urgent advocacy and legislative priority. To help physician advocates and lawmakers get a stronger grasp on the complicated terrain of Medicare physician payment reform, the AMA has developed a series of additional explainers on:
- The Medicare Economic Index (PDF).
- Medicare physician payment adequacy: Budget neutrality (PDF).
- Merit-based Incentive Payment System (PDF).
- Advancing value-based care with alternative payment models (PDF).
Visit AMA Advocacy in Action to find out what’s at stake in reforming Medicare payment and other advocacy priorities the AMA is actively working on.
