Evaluating the Current State of Quality Measure Reporting in the Merit-Based Incentive Payment System

The Merit-Based Incentive Payment System (MIPS) requires physicians to report quality measures along with other metrics that are used to determine an annual percentage adjustment to physician Medicare Part B payments. Unfortunately, physicians have been forced to choose from an ineffective, limited set of quality measures. This has led to an overreliance on process measures, which fail to stratify physician performance effectively; it has also led to differences in the number of reporting options across specialties, resulting in unequal opportunity for physicians to succeed in MIPS. Using Centers for Medicare and Medicaid Services (CMS) public use file data from 2021-2024, we found that the number of quality measures available for reporting has declined annually since 2021, and that process measures accounted for a majority, 59% or more, of yearly measures. More than 33% of yearly measures failed to stratify physician performance effectively, and significant variability in the number of 2024 reporting options existed across specialties. Policymakers should ensure that future modifications to the MIPS program provide equal opportunity for physicians to achieve a positive Medicare Part B payment adjustment.