Tell Congress to support the Medicare Physician Data-Driven Performance Payment System Act

The Florida Society of Rheumatology is sharing the following advocacy opportunity from the American Medical Association and its Physicians Grassroots Network.

The Physicians Grassroots Network empowers physicians to advocate for smarter health care solutions and protect the patient-physician relationship.

TAKE ACTION NOW

For the past decade, the Merit-based Incentive Payment System (MIPS) has forced physicians to play a game of quality evaluation—one where physicians lose and patients pay the price. Now, Congresswoman Mariannette Miller-Meeks, MD (IA-01) and Congressman Herb Conaway Jr., MD (NJ-03) have introduced H.R.8622, a practical solution that will stabilize the MIPS program to ensure physicians can provide and patients can receive high quality care in their local community.

Under MIPS, CMS evaluates an individual physician's performance by measuring quality, cost, health IT, and improvement activities to generate a total score on a scale of 0-100 points. Based on the score's comparison to the MIPS national benchmark, physicians receive a penalty, neutral payment adjustment, or a bonus. The penalties and bonuses range from plus or minus 9 percent with the historical data demonstrating that low performing practices fund the bonuses for high performers. 

As a result, the combination of excessive quality measurement programs and the win-lose "tournament model" inherent to MIPS has created three major issues: 1) significant administrative burden 2) steep penalties that disproportionately hurt small, rural, and independent practices, and 3) a lack of timely and actionable data. 

MIPS costs $12,800 and 202 hours per physician per year in paperwork and compliance, according to a 2022 JAMA study. The CMS data from 2023 Quality Payment Program (QPP) Experience Report shows that 29% of small practices, nearly 50% of solo practitioners, and 18% of rural practices received a MIPS penalty —jeopardizing patient access to local care, especially in underserved communities.

H.R. 8622, the Medicare Physician Data-Driven Performance Payment System (DPPS) Act of 2026 would solve these problems by:

• Freezing the performance threshold at 75 points for at least three years.

• Eliminating the MIPS win-lose "tournament style" payment adjustments (i.e., the +/- 9%) to ensure physicians are no longer subjected to steep penalties.

• In lieu of penalties, the legislation links physicians' MIPS performance to a portion of their annual payment update (e.g., either the existing 0.25% under MACRA or the percentage increase in the Medicare Economic Index (MEI), should it be enacted in a separate bill).

• Mandate CMS fulfills its statutory obligations under MACRA to share data on a quarterly basis with the MIPS performance year, so physicians can leverage this data to implement changes that would improve patient care and use resources more efficiently.

• Failure by CMS to provide MIPS physicians with three quarters worth of data during the performance year results in doctors receiving the highest possible payment update.



Tell Congress: Physician performance is not a game—patients deserve real improvements, not arbitrary penalties. Urge your representative to co-sponsor H.R.8622 and ensure physicians can deliver quality care in their local community.