Medicare’s Merit-based Incentive Payment System (MIPS) came into effect in 2017. To understand physician practice leaders’ perception of the major value-based purchasing program (including the program’s effect on patient care, administrative burden, and rationale for participation), members of the Division of Health Policy and Economics and a colleague completed a new Journal of General Internal Medicine study. Dr. Lawrence Casalino, professor of population health sciences; Dr. Dhruv Khullar, assistant professor of population health sciences; Dr. Amelia Bond, assistant professor of population health sciences; Yuting Qian, research coordinator; Eloise O’Donnell, senior research program manager; and David Gans, a senior fellow at the Medical Group Management Association, conducted interviews with leaders of 30 physician practices of various sizes and specialties across the U.S. A number of themes arose, including seeing MIPS as a continuation of previous value-based payment programs and a precursor to future programs, and viewing the program as more relevant to primary care practices than other specialties, among other perceptions. Reported challenges included administrative burden, small incentives, irrelevant measures, and frequent programmatic changes. There was no clear perception of whether the program actually improves patient care. The researchers suggest that these findings might help policymakers improve MIPS in the future.