In a letter to leaders of the GOP and Democratic Doctors Caucuses, ASGE recommended the current Medicare Merit-based Incentive Payment System (MIPS) should be repealed and suggested that physician quality and patient outcomes should instead be assessed through RVU-based incentive structures that leverage quality measure concepts recognized as priorities by specialty societies.
For example, ASGE highlighted adenoma detection rate (ADR) as a key outcome measure and quality metric. The letter noted that while gastroenterologists have done a great job of continually increasing their ADRs, it isn’t tied to better reimbursement. ASGE suggested that since Medicare claims data can detect a CPT code for colonoscopy together with an ICD-10 code indicating a positive stool-based test (SBT), Medicare could increase reimbursement to physicians who perform a colonoscopy within six months of a positive SBT. Such an approach would eliminate a separate program that requires the reporting of quality measures.
The letter was in response to a request for feedback on MIPS and the Centers for Medicare and Medicaid Innovation as lawmakers begin formulating proposals to reform the Medicare physician payment system.
ASGE also signed a letter led by the Physician Clinical Registry Coalition requesting that clinician-led clinical data registries be fully leveraged for quality improvement or value-based payment.