This week, the Medicare Payment Advisory Commission (MedPAC), an advisory committee with no force of law, met and discussed whether to make a recommendation to do away with the Merit-Based Incentive Payment System (MIPS) and replace it with a system that measures the quality and value of physician services at a population level. MedPAC staffers envision a system that would measure performance of large groups of physicians through claims-based measures calculated by CMS. While most commissioners favored moving forward with a formal recommendation, some commissioners cited concerns that the plan would be primary care-based and prevent specialists from having much influence over their scores. In addition, commissioners considered whether they should not seek an alternative to MIPS, but recommend CMS develop new alternative payment models and incentives to join them, rather than keep physicians in fee-for-service. MedPAC is aiming to vote on a formal recommendation at its December meeting. Repealing MIPS in accordance with any potential recommendation from MedPAC would require Congressional action to amend the MACRA statute and is unlikely to occur.